Dupuytrens Contracture treatment

Understanding Dupuytren's Contracture & Your Treatment Options

What is Dupuytren's?

In very brief terms Dupuytrens contracture is a condition where thick cords, pits or nodules form

under the skin of your palm/fingers, pulling fingers into a bent position. It’s not curable, but treatments can straighten fingers and improve function. In some people the disease does not progress to a stage where surgery might be an option. Whilst the nodules can be painful when they are forming, it is not a painful condition in itself.

See the treatment options below for a more thorough explanation of what can be done.

Key Takeaways

. Early stage? → Radiotherapy may stop progression.

. Finger already bent? → Collagenase or needle procedures are less invasive; Surgery is most durable.

. Recurrence is common: Dupuytren’s often returns or develops in other digits – no treatment is permanent.

. Splints don’t prevent Dupuytren’s: Only used after procedures to help reduce early recurrence of contracture.

Treatment recommendations depends on your finger bend severity, age & health and willingness to accept recurrence risk.

Sources: International Dupuytren Societies, 2023 Clinical Guidelines (simplified for

patients).

You can download a copy of my information leaflet outlining all these choices

Best for: Early stage (lumps/cords present, no finger bending yet).How it works: Low-dose radiation slows down disease progress by stopping the

cell type which characterises the disease process from growing..

Key facts:

Stops worsening in ~80% of early cases (5-year data).

Not effective once fingers start bending.

Side effects: Mild skin dryness. Not for everyone – discuss risks with your

doctor.

In most areas of the UK this is not available on the NHS. It is available privately

and covered by most Private Medical Insurers.

https:/ /Www.Dupuytrensuk.com is a private clinic run in multiple locations in

the UK which provides radiotherapy for this condition.

Best for: Simple cords causing finger bending.

How it works: Doctor uses a needle to puncture multiple holes through the cord

to allow it to break when the finger is stretched out giving immediate correction

in 70-95% of people . This is performed under local anaesthesia.

Key facts:

Minimally invasive: No stitches, quick recovery.

High recurrence: 50-65% within 3 years.

Risks: Skin tears, nerve injury (<1%).

This involves an operation to remove the thickened cords and nodules

Limited Surgery: Removes diseased tissue (most common).

Skin Graft Surgery: For severe/recurrent cases (removes tissue + replaces

skin).

Best for: Contractures over 30 degrees in the MCP or PIP joints

How it works: the skin is opened thourgh a zig-zag incision under local, regional or general anaesthetic up the finger in order to isolate the disease tissue from the nerves and vessels which run close to it and then remove the tissue. The joints will usually then straighten but sometimes require further releases to be performed if they have stiffened due to being held bent for a long time. It can successfully straighten the joints in 70-95% of patients. There are scars and stitches which need to be managed and exercises to perform. Recovery usually takes approximately 6-8 weeks and most people will have a period off work and driving during this time.

Moderate recurrence rate: 30-40% within 5 years

Risks: Infection, scar problems, nerve or vascular injury if severe (<1%) more if this is revision surgery.

You can download a copy of my information about Dupuytrens fasciectomy surgery here.

Best for: Finger bending ≥20° (palpable cord required).

How it works: An enzyme injection dissolves the tight cord. Performed in clinic.

Key facts:

Quick procedure: Often 1-2 injections.

80% success straightening fingers (especially knuckles).

Recurrence: ~40% within 4 years (higher for fingertip joints).

Side effects: Bruising, swelling, rare tendon injury.

This treatment was withdrawn from the UK market by the manufacturer for

commercial reasons but may be available again in the future.