Dupuytren's disease affects connective tissue beneath the skin of the palm. Nodules and cords develop first; fingers may later bend progressively and no longer straighten fully. This is not shortening of the flexor tendons. Progress is often slow and varies between people. Treatment is particularly relevant when finger extension and hand function are affected. Small nodules without limitation do not automatically need surgery.
Rapidly increasing restriction or new sensory disturbance needs prompt assessment. After a procedure, pale or cold fingers, severe increasing pain or signs of wound infection require urgent review.
Causes and risk factors
Inherited predisposition often plays a role. The condition becomes more common with age and may be associated with diabetes and other factors. A single clear trigger is usually not identifiable. Both hands can be affected. The change is benign and not contagious. It should nevertheless be distinguished from other causes of lumps or a locking finger, which may require different treatment.
Typical symptoms
Early signs include firm nodules, skin dimpling or cord-like thickening, usually towards the ring or little finger. Pain is often not the main problem. A finger may gradually stay bent, making it difficult to place the hand flat on a table. Gloves, washing or grasping larger objects can become difficult. Progress varies; not every early finding develops into a severe contracture.
Diagnosis
We examine nodules, the course of the cords, loss of extension and joint movement. Sensation, skin condition and previous treatments also matter. Clinical assessment is often sufficient; typical findings do not need additional imaging. The tabletop test can provide a practical guide over time but does not replace examination. Before treatment, we assess any permanent joint stiffness and realistic improvement in relation to risks.
Non-surgical treatment
Observation is often appropriate for early disease with little limitation. Regularly checking the ability to straighten the fingers helps identify change. Vigorous stretching or massage does not reliably remove the abnormal cords. Possible additional measures are discussed without promises of cure. Increasing functional difficulty should be reassessed in good time. A visible or cosmetically troublesome nodule alone does not necessarily require treatment.
Surgical options
For significant contracture, targeted division of a cord or removal of diseased connective tissue may be considered according to the findings. Selected procedures are part of our outpatient service; complex or repeatedly operated disease may require specialist care. The aim is better extension and function, not guaranteed removal of the underlying predisposition. Recurrence is possible. Nerve or vessel injury, skin problems and residual stiffness are discussed alongside the likely demands of aftercare.
Aftercare and rehabilitation
Wound care and a coordinated movement programme are important after a procedure. Hand therapy and splinting may be prescribed according to the findings; they are not identical for every situation. Swelling, scar sensitivity and return of movement take time. Regular reviews help identify problems early. Cords can recur even years later. Full straightening cannot always be achieved in severe longstanding contractures.
Common questions
Are the tendons shortened?
The primary change is in the palm’s connective tissue. With longstanding disease, joints may become stiff as well.
Can surgery cure the disease?
It can improve function. The predisposition remains, so new or recurrent cords are possible.
When should I seek assessment?
When your hand no longer lies flat, fingers become increasingly bent or everyday tasks get harder.
Arrange a consultation
We discuss which treatment is suitable for your findings and which procedures are available within our outpatient service during a personal consultation. Outpatient operations take place at an external surgical centre.
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Further reading
Selected external resources about this condition. Some linked publications are in German.
Medical background
Sources & further information
These professional and patient resources provide further information about this condition. The text on this page is independently written.
NHS: Dupuytren’s contractureAAOS: Dupuytren’s disease