Release of Dupuytren’s Contracture | PAX Medicus Medical Tourism UK

Release of Dupuytren’s Contracture

Dupuytren’s disease causes thickening of the palmar fascia, leading to permanent contractures of the fingers. Early treatment helps preserve hand function and prevent progression.

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What is Dupuytren’s disease?

Dupuytren’s disease, also called palmar fibromatosis, is a progressive thickening of the palmar fascia – a strong fibrous layer protecting the hand. As the fascia becomes thicker due to excessive fibrosis, painless nodules form and gradually develop into tight cords.

Over time, these cords cause permanent flexion contractures of the fingers. Without timely treatment, the contracture becomes fixed and may severely limit hand function.

Symptoms of Dupuytren’s disease

Early symptoms

  • Painless, firm nodules in the palm
  • Most often along the ring finger
  • Nodules slowly merge into fibrous cords
  • Progression occurs over months or years

Advanced symptoms

  • Inability to fully straighten one or more fingers
  • Permanently flexed finger position
  • Tingling, numbness or paraesthesia
  • Loss of hand function in daily activities

Delaying treatment increases the risk of irreversible contracture, making surgery less effective.

Who is at risk and what causes it?

The exact cause of Dupuytren’s disease is unknown. Research suggests a strong genetic link, but trauma and repeated strain may also contribute. A single injury can sometimes trigger onset.

Possible causes

  • Genetic predisposition
  • Micro-injuries or repetitive strain
  • Previous hand trauma

High-risk groups

  • Men over the age of 50
  • Patients with diabetes
  • People with epilepsy
  • Heavy alcohol consumption
  • Smokers

How is Dupuytren’s disease diagnosed?

Diagnosis is based on a clinical consultation and physical examination. The specialist evaluates nodules, cords, mobility and sensation, and may request imaging if needed.

Diagnostic steps

  • Detailed consultation and medical history
  • Assessment of nodules and contracture severity
  • Evaluation of finger mobility and sensation
  • Ultrasound for tissue assessment (most common)
  • X-ray or MRI in atypical cases
  • Photographic documentation for monitoring progression

Can Dupuytren’s disease be treated without surgery?

Because Dupuytren’s disease progresses slowly, most patients seek medical help once the contracture is already advanced. At that stage, surgery is often necessary. However, early-stage treatment options may temporarily slow progression.

Early-stage treatments

  • Corticosteroid injections
  • Enzymatic fasciotomy (collagenase injection)
  • Needle aponeurotomy (needle fasciotomy)

Not recommended

  • Splints
  • Stabilisers
  • Physical therapy alone (not effective)

Surgical treatment options

In open aponeurotomy, several small incisions are made in the palmar fascia to release the contracture. The diseased tissue is not removed. This procedure is performed under local anaesthesia and provides symptomatic relief, but recurrenc

Fasciectomy involves removing the diseased fibrotic tissue through an incision in the palm. It is performed under local or general anaesthesia and typically allows same-day discharge. Removing the cords enables the fingers to straighten.

Recovery after Dupuytren’s surgery

Immediately after surgery

  • Same-day discharge in most cases
  • Thick dressing applied to protect the wound
  • Stitches removed after around two weeks
  • Hand movement should be limited initially

Long-term recovery

  • Functional limitations for 2–6 weeks
  • Physiotherapy recommended after initial healing
  • Splinting may be used temporarily
  • Keep dressing dry and change every 2–3 days
  • Pain controlled with oral anti-inflammatory medication

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