What is Dupuytren's contracture?

Dupuytren’s contracture is a relatively common medical condition that causes one or more of the fingers to bend towards the palm of the hand. It usually affects the ring finger and the little finger next to it, although it can affect any finger or thumb on one or both hands.

What are the symptoms of Dupuytren's contracture?

The first sign is one or more small lumps, called nodules, on the palm of your hand. They are not cancerous. 

Over time these nodules get bigger and form tough cords of tissue under the skin. These cords can get shorter, which pulls your fingers towards your palm. This can make everyday tasks more difficult. 

Dupuytren’s contracture can affect people in different ways. Some people only have nodules, but their fingers don’t get pulled in. Others find their hand closing up. Some find the condition painful, while others don’t. Some say their hand itches, while others don’t.

What causes Dupuytren’s contracture?

Dupuytren’s contracture occurs when the layer of fibrous tissue in the palm (called the palmar fascia) becomes thicker and tighter than usual. 

It is not clear why this happens. It seems to have a genetic basis, since it runs in families and is more common in people of Scandinavian descent. 

It is also more common in people who have diabetes or epilepsy, or who smoke or drink heavily. 

How is Dupuytren’s contracture diagnosed?

If you think you might have Dupuytren’s contracture, see your doctor. They can diagnose it simply by looking at your hands, and no tests are needed.

How is Dupuytren’s contracture treated?

If the contractures aren’t causing you any problems, you don’t need treatment. 

If your hand feels uncomfortable or painful, you could try:

• applying heat to help loosen the tissues
• gently massaging your palm
• doing exercises to bend your fingers away from the palm.

Using a physiotherapist or occupational therapist (sometimes called hand therapists) may also help.

If Dupuytren’s contracture is causing more serious problems, see your doctor. They might suggest:

• steroid injections to reduce inflammation
• injections of a medicine called collagenase, which can loosen your fingers sufficiently so they can be straightened
• needle aponeurotomy – where the doctor inserts a small needle into different parts of your hand to break up the tissue
• fasciectomy – where a surgeon cuts out some of the thickened tissue 

All these treatments can help, but none are guaranteed to work.

When to seek help

Talk to your doctor if your hand is bothering you. Your doctor might refer you to a physiotherapist, a hand therapist or to a hand surgeon.