Dupuytren's contracture is a disease involving the ligaments (or fascia) within the skin of the palm of the hand.
In people who develop this condition, the fingers may gradually become bent or flexed in towards the palm. When it is no longer possible to place the palm of the hand flat on a table, treatment is usually needed to prevent the bent finger deformity getting worse.
Signs and symptoms of Dupuytren's contracture
Dupuytren's contracture mainly affects the ring and little fingers. You can have it in both hands at the same time.
It starts with lumps, dimples or ridges on your palm. Gradually, over months or years, your finger may become bent into the palm.
See a GP if one or more of your fingers are bent and:
- you are unable to place your hand flat on the table - this is known as the 'table top test'
- you're having difficulty with daily activities
Some other common conditions affecting the hand are:
Small, soft lump on the wrist or finger joints
Hard, raised, rough skin on the palms
Finger 'catching' or getting stuck when you move it
Treating Dupuytren's contracture
Dupuytren's contracture tends to get slowly worse over many months or years. Speak to a surgeon about your options.
There are 3 main types of treatment.
Surgery to straighten the fingers
The operation to correct the bent or contracted finger is called fasciectomy. The surgeon makes a cut along your palm and finger so they can straighten it.
Things you should know about the operation:
- You can be under general anaesthetic (asleep) or local anaesthetic (your hand is numbed)
- You can leave the hospital the same day
- Recovery time is 4 to 12 weeks
- risks of this operation include numbness in a finger, wound healing problems, infection and stiffness
Nine out of ten patients have no problems after the operation.
Using a needle to straighten the fingers
This procedure is called a needle fasciotomy. A needle is inserted into several places along your palm and finger to loosen and straighten it.
When you have a needle fasciectomy:
- you will have a local anaesthetic (your hand is numbed)
- you can leave the hospital the same day
- your recovery time is up to 2 weeks
- contracture is more likely to come back than with surgery
- risks include a cut opening up in your skin, pain and numbness
What to expect after treatment
Recovery and aftercare can vary but generally you may:
- have a cast or support (splint) on your hand for a few days
- have some pain, stiffness, bruising and swelling for a few weeks
- need to wear a splint while sleeping for 3 to 6 months
- be advised to do hand exercises for up to 6 months – a specialist hand therapist will supervise your recovery exercises and rehabilitation
It is very important to start using your hand again for every day activities as soon as possible after the operation.
It may be a few weeks before you can return to all your activities.
Causes and prevention
The condition happens when tissue near your fingers becomes thicker and less flexible.
Dupuytren's disease is usually an inherited condition. Most patients with this condition have elderly relatives who have had the condition.
It has also been linked to:
- drinking lots of alcohol
- having diabetes or epilepsy
Whichever form of treatment is used, there is a risk of the condition returning.
Usually the disease does not come back for many years.
Content supplied by the NHS and adapted for Ireland by the HSE.