Dupuytren’s contracture is a condition affecting the connective tissue (fascia) in the hand. Over many years the affected tissue in the palm of the hand and fingers contracts, causing flexion of the fingers – usually the ring and little.
Dupuytren’s requires surgery when it is affecting the function of a persons hand. This will vary depending on their work or hobbies, but is usually when it affects the ability to place a hand flat on a table. Usually the diagnosis is clear and no imaging or other tests are required.
Surgery involves removing the tight bands of fascia which are flexing the fingers under a general anaesthetic. The skin is closed in a zig-zag pattern to prevent a scar contracting and sometimes a small skin graft is required.
In some patients a newer, less invasive treatment may me possible where an enzyme called collagenase can be injected into the cord, breaking down the contracted tissue and allowing the finger to be straightened without surgery.
Hand therapy is very important after any Dupuytrens procedure, with a series of exercises and possibly splinting to achieve an optimal result. This continues for around 6-8 weeks.