What is Dupuytren's disease?
is an abnormal thickening of tissue beneath the skin in the palm of the hand.
It occasionally occurs in the soles of the feet. This condition usually
progresses very slowly and may never require treatment. But for some,
Dupuytren's disease may eventually cause the fingers to bend so that they
cannot be straightened (contracture).
Dupuytren's disease usually
does not cause pain. The first noticeable symptom often is a small lump
(nodule) felt in the palm, usually near the base of the fingers. A fibrous,
ropelike cord may gradually develop in the palm tissue (fascia). The cord pulls
the finger toward the palm (Dupuytren's contracture). Eventually you will not
be able to flatten your palm on an even surface, such as a table.
What happens in Dupuytren's disease?
When it is
severe, Dupuytren's contracture can make everyday activities-such as picking up
items, putting on gloves, or washing hands-difficult or impossible.
What are the nonsurgical treatments for Dupuytren's disease?
In mild cases, regular stretching of the involved
fingers may be enough to maintain your hand mobility. Twice-daily sessions of
massaging the hand and then gently stretching your fingers back relieves
tightness and helps keep the fingers flexible. For some people with mild
disease, hand function may be maintained with physical therapy and
Injections of lidocaine or
corticosteroids or both may provide some temporary
relief from your symptoms. Other treatments that may provide some relief
What are the surgical options for Dupuytren's disease?
Surgery for Dupuytren's disease may relieve severe cases of contracture
but will not cure the disease. The most common surgery done for Dupuytren's
disease is removal of the abnormally thick and fibrous tissue (fasciectomy). If
your palm skin has become stuck (adhered) to the abnormal tissue, the skin may
be removed along with the tissue.
Another surgical procedure done
in some cases of Dupuytren's disease is fasciotomy, in which the cords of fiber
in the palm are divided through small incisions. This procedure is usually
reserved for people who, because of general health, are not good candidates for
fasciectomy or who have recurrent disease.1
Surgery usually provides relief from contracture and restores mobility
in the fingers, but the condition may return.2
Delaying surgery until you have a severe contracture of the fingers makes
surgery and recovery more difficult.
What are the possible complications from surgery for Dupuytren's disease?
Complications are common during surgery for Dupuytren's
disease. They occur in about 1 in 5 cases.3
Complications can include:
- Delayed wound healing. This is the most
common complication and it is usually mild.
- Infection of the
- Stiffness or
contracture, with the fingers still being
- Nerve injury.
- Loss of circulation in the
- Collection of blood or blood clots in the tissues
- Damage to the skin, which results from trying to
surgically separate the skin from the diseased tissue (palmar
- Reflex sympathetic dystrophy.
Surgery usually improves but may not completely restore
hand function. Even with successful surgery, thickened palm tissue may develop
again in the same place or in a new area of the hands. Reoperation may be
necessary to maintain hand function.
If surgery is done, what follow-up exercises and treatment might be required?
After surgery, the disease may recur in the same
area or may appear in a new location. But the outcome may be better if you
routinely do finger exercises and use splints as instructed by your health
A physical or occupational therapist can teach you
how to do exercises to gently move your finger joints through their normal
range of motion. These exercises help prevent joint stiffness. Range-of-motion
exercises do not include motions that stress or overextend the joint.
Splints may be used after surgery for about 8 to 10 weeks to help
restore hand function and prevent symptoms of Dupuytren's disease from
recurring. Splints support your palm and help straighten your fingers during
the healing process. In some cases, splints are worn only at night, but in
others they are worn at all times, except when the wound needs cleaning or
during finger exercises. Your health professional will help you learn how and
when you wear the splint during recovery.
If you need more information, see the topic