Diagnosis
Most of the time, Dupuytren contracture can be diagnosed by simply looking at and feeling the hands. Other tests are rarely necessary.
During the exam, a healthcare professional:
- Compares both hands and looks for changes in the skin of the palms, such as dimpling or puckering.
- Gently presses on the hands and fingers to feel for firm bumps or tight cords of tissue.
A simple test called the tabletop test also may be used. You place your hand flat on a table. If your fingers cannot fully straighten to lie flat, treatment may be needed.
Treatment
If Dupuytren contracture is mild, causes no pain and doesn't limit your daily activities, you may not need treatment. Your healthcare professional may suggest simply watching to see if it gets worse. You also can check at home with the tabletop test. Place your hand flat on a table to see if your fingers can fully straighten.
If symptoms are mild, small changes can make daily tasks easier:
- Wrap handles with cushion tape so they are larger and easier to grip.
- Wear padded gloves when doing grasping tasks.
If treatment is needed, the goal is to loosen or remove the tight cords that pull your fingers toward your palm. But no treatment is a permanent cure. Over time, the cords may grow back and the fingers may bend again. The best treatment option depends on how serious your symptoms are and your overall health.
Needling
This procedure also is called needle aponeurotomy. A thin needle is inserted through numbed skin to puncture and break apart the cord of tissue that's pulling the finger down. The condition often comes back, but the procedure can be repeated.
The needling technique has several advantages. There are no large cuts to heal. It can be done on several fingers at the same time. It can be done in the office setting instead of the operating room. A disadvantage is that it can't be used in some places in the finger because it could damage a nerve or tendon.
Injections
- Steroids. Injections into the hard lump may help soften it and relieve pain, especially early in the disease.
- Collagenase, also called enzyme treatment. An injection of a special enzyme called collagenase weakens the cords. At a follow-up visit a few days later, your healthcare professional moves your hand to release or break the cords and straighten the finger. This can improve or even correct the condition for months to years.
Radiation treatment
Radiation treatment sometimes can be used when Dupuytren contracture is just starting. It also may be used after a procedure or surgery to help prevent the condition from coming back.
Surgery
Surgery may be recommended for more serous symptoms. During surgery, the surgeon removes or releases the thickened tissue. If symptoms are very advanced, the skin also may be removed. A skin graft is used to cover the wound.
Surgery usually results in a more complete and longer lasting release than that provided by the needling or enzyme methods. But recovery takes longer.
Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and home remedies
If you have mild Dupuytren contracture, you can protect your hands by:
- Building up the handles of tools with padding, such as cushion tape, so you don't need to grip tightly.
- Wearing gloves while doing gripping tasks.
Preparing for your appointment
Your healthcare professional may refer you to a doctor who specializes in bones and joints, called an orthopedic surgeon.
What you can do
Before your visit, think about and be ready to talk about the following with your healthcare professional:
- Whether anyone in your family has the condition.
- Treatments you've tried so far, including how they worked.
- What medicines, vitamins or supplements you take regularly.
What to expect from your doctor
You may be asked:
- When did your symptoms start?
- Are they getting worse?
- Do you have pain in your hand?
- How does the condition affect your daily activities, such as dressing, working or using your hands?