16941 Dupuytrens Contracture

Overview

Dupuytren's contracture is a hand condition that causes one or more fingers to bend toward the palm and become stuck in that bent position. It happens when the thick band of tissue under the skin in the palm (fascia) grows thicker and shorter.

Yes, it is fairly common, especially in people over 50. It affects about 1 in 20 people in the UK, and many more men than women.

It most often affects men over 50, and people of Northern European (Scandinavian or Celtic) descent. It also runs in families.

Symptoms

Common symptoms

• A small lump or knot in the palm
• A dimple or pit in the palm
• A hard cord that extends from the palm toward a finger
• A finger that gradually curls toward the palm and cannot be straightened fully

Symptoms in children

• Dupuytren's contracture is very rare in children. When it does happen, it looks like a thickened cord or bent finger in the hand, and it should be checked by a doctor.

Symptoms in older adults

• In older adults, the condition tends to get worse slowly over many years. It may affect daily activities like shaking hands, putting on gloves, or gripping objects.

Causes

Main causes

• The exact cause is not known. The condition happens when the connective tissue in the palm (the fascia) becomes thicker and shorter, pulling the finger.

Risk factors

• Growing older
• Being male
• Having a family member with Dupuytren's contracture
• Smoking
• Drinking more than a moderate amount of alcohol
• Having diabetes

When to see a doctor

See a doctor urgently if:

• If you suddenly cannot bend or straighten your fingers at all
• If you have severe hand pain or numbness
• If there are signs of infection such as redness, heat, or fever

Book a routine appointment if:

• If you notice a new lump or cord in your palm
• If a finger starts bending toward the palm and it is hard to flatten your hand
• If the curving is getting in the way of daily tasks like washing, dressing, or holding things

Diagnosis

A doctor or specialist can usually diagnose Dupuytren's contracture by looking at your hand, feeling the palm, and checking how far each finger can straighten.

Tests that may be done

• A physical exam of the hand is usually the only test needed
• Your doctor may ask you to place your hand flat on a table to see how much your fingers lift off the surface
• No X-rays or blood tests are required, unless another problem is suspected

What to expect at your appointment

Your doctor will measure the bend in your fingers and ask about any pain or difficulty with daily activities. They may refer you to a hand specialist if the contracture is getting worse.

Treatment

There is no cure for Dupuytren's contracture, but there are several treatments that can help straighten your finger and improve hand function. Not everyone needs treatment, especially if the bend is mild and not bothering you.

Self-care at home

• Warm your hands gently in warm water before stretching
• Do gentle finger stretching exercises as shown by a hand therapist
• Use hand cream or oil to keep the skin soft and flexible
• Avoid heavy gripping or repeated pressure on the palm if it bothers you

Medical treatments

Treatment options depend on how tight the cord is and how much your hand function is affected. A doctor may suggest a tiny needle procedure to break the cord (percutaneous needle fasciotomy), or a special enzyme injection that softens the cord so it can be broken with gentle pressure. Surgery to remove the tight tissue may be considered for more severe contractures. A hand specialist will help you decide the best plan for you.

When is surgery considered?

Surgery may be recommended if the finger is bent significantly, you cannot use your hand for daily tasks, or other treatments have not worked. Surgery can help straighten the finger, but it can take weeks to heal and the condition may still come back.

Living with this condition

If Dupuytren's contracture affects your hand, you can still do most daily activities. You may need to switch to softer grips, avoid tight pinching movements, and use tools with wider handles to make tasks easier.

Lifestyle tips

• If you smoke, ask your GP or pharmacist about support to quit
• Limit alcohol to within national guidelines
• Keep your hands warm in cold weather to help tissue flexibility
• Protect your palm from injury with gloves during DIY or gardening

Diet and exercise

There is no special diet proven to stop Dupuytren's contracture. Eating a balanced diet and staying active can help your overall health. Gentle hand exercises, such as opening and closing your fingers, can help maintain range of motion, but they will not cure the condition.

Mental health and emotional wellbeing

Living with a hand that is not fully straight can be frustrating, especially if you rely on your hands for work or hobbies. It is common to feel self-conscious or anxious. Talk to your doctor about how you are feeling – you don't have to manage alone.

Prevention

There is no known way to prevent Dupuytren's contracture. Some risk factors, such as family history and age, cannot be changed. However, not smoking and keeping alcohol intake low may reduce your risk or slow the condition.

Vaccines

No vaccine can prevent Dupuytren's contracture.

Screening programmes

There is no routine screening test for Dupuytren's contracture. If you notice a lump or a bent finger, get it checked by your GP.

Complications

If left untreated

• The finger may continue to bend toward the palm and become permanently fixed
• Difficulty using the hand for gripping or washing
• A feeling of a tight cord in the palm that may be uncomfortable

Long-term outlook

Most people with Dupuytren's contracture do not have major problems. Even when the finger bends, treatment can usually improve it. The condition may come back after treatment, but many people get many good years of use from their hand.

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