Dupuytren Contracture

At Mayo Clinic Healthcare in central London, our orthopaedic specialists assess and manage Dupuytren contracture.

You may notice a lump or thickened area in the palm of your hand. Over time, one or more fingers may begin to bend towards your palm, making them difficult to straighten.

Your specialist will examine your hand, confirm the diagnosis, and discuss whether monitoring or treatment is appropriate for you.

Dupuytren contracture affects a layer of tissue beneath the skin of the palm called the fascia.

The tissue gradually becomes thicker and tighter. Firm lumps, called nodules, may develop in the palm. These can form cord-like bands that pull one or more fingers towards the palm.

The condition usually develops slowly over months or years. It often does not need treatment in its early stages. However, treatment may be considered if it becomes difficult to straighten your fingers or use your hand during everyday activities.
Symptoms often develop gradually. The condition is not usually painful, although some people may notice tenderness when a lump first develops.

Signs and symptoms may include:

A firm lump or thickened area in the palm

Dimpling or puckering of the skin

A cord-like band beneath the skin

One or more fingers bending towards the palm

Difficulty fully straightening a finger

Difficulty placing your hand flat on a table

Reduced hand function during everyday activities

The ring and little fingers are most often affected. The condition may affect one or both hands.
The exact cause of Dupuytren contracture is not known. Changes in the tissue beneath the skin cause it to become thicker and less flexible.

Factors associated with a greater likelihood of developing the condition include:

Older age

A family history of Dupuytren’s contracture

Northern European ancestry

Diabetes

Smoking

Heavy alcohol use

Being male, although women can also develop the condition

Having one or more of these factors does not mean that you will develop Dupuytren contracture. Some people develop it without any known risk factors.
A specialist can usually diagnose Dupuytren contracture by examining and feeling your hands. Imaging tests are rarely needed.

During your consultation, your specialist may:

Ask when you first noticed the changes

Discuss whether the condition affects your work or daily activities

Examine the skin of your palms

Feel for lumps and tight cords beneath the skin

Assess how far you can bend and straighten your fingers

Compare both hands

Your specialist may also ask you to place your hand flat on a table. This is sometimes called the tabletop test.

Additional tests may be recommended if your specialist thinks another condition could be causing your symptoms.
The right Dupuytren contracture treatment depends on how far your fingers have bent, whether the condition is progressing, and how it affects your daily life.

Treatment can improve finger position and hand function, but it does not remove the underlying tendency to develop the condition. Dupuytren contracture can return after treatment.

Monitoring

You may not need treatment if you can straighten your fingers and use your hand without difficulty.

Your consultant may suggest monitoring the condition. You can also check for changes by occasionally placing your hand flat on a table.

Contact your specialist if the bend becomes more noticeable or begins to affect everyday tasks.

Support for daily activities

Your consultant may suggest practical changes that make activities easier. These may include adapting handles, equipment, or the way you complete certain tasks.

Exercises cannot stop Dupuytren’s contracture from progressing or straighten an established contracture. However, hand therapy may form part of your recovery after a procedure.

Needle fasciotomy

Needle fasciotomy may be suitable for some people with a clearly defined cord of tightened tissue.

During this procedure, the skin is numbed with a local anaesthetic. A specialist uses a fine needle to divide the cord so that the finger can be straightened.

Recovery is generally faster than after open surgery, but the contracture is more likely to return. The procedure is not suitable for every cord because of the position of nearby nerves and tendons.

Surgery

Surgery may be recommended when the contracture significantly affects your hand function.

Procedures may include:

Fasciectomy: Removing some of the thickened tissue

Dermofasciectomy: Removing the affected tissue and overlying skin, followed by a skin graft

Your specialist will explain the potential benefits, recovery period, and risks of each option.

Mayo Clinic Healthcare in London does not provide surgery. If surgery is recommended, your consultant can refer you to an appropriate surgical specialist and help coordinate your ongoing care.
At Mayo Clinic Healthcare, you will receive consultant-led care based on your symptoms, hand function and daily needs.

Your care may include:

Assessment by an experienced orthopaedic specialist

A clear explanation of your diagnosis

A personalised monitoring or treatment plan

Access to additional investigations when clinically appropriate

Referral for procedural or surgical treatment when needed

As part of the globally recognised Mayo Clinic network, we combine local care in London with international clinical expertise to help you understand your condition and support you throughout your care.

Private health insurance

Mayo Clinic Healthcare works with all major private health insurance providers, including AXA PPP, Aviva, BUPA, Health Partners Group, Vitality Health and WPA. Self-pay arrangements are also available.

Book a private assessment

Consider arranging an assessment if:

You have a persistent lump or thickened area in your palm
One or more fingers are beginning to bend towards your palm
You cannot place your hand flat on a table
The condition is making daily activities more difficult

Our specialists can assess your hand and discuss whether monitoring or Dupuytren contracture treatment may be appropriate for you.

Request an appointment or call +44 (0) 207 871 2575 to speak with our team.

Medically Reviewed by

Mr Karthik Karuppaiah, Consultant Orthopaedic Surgeon