Dupuytren contracture

Overview

Dupuytren contracture is a condition where the tissue under the skin of your palm thickens and tightens, causing one or more of your fingers to bend toward your palm. It most often affects the ring and little fingers.

Dupuytren contracture is fairly common, especially in people of Northern European descent. About 3–6% of the general population in many countries have it.

It most often affects men over 50, though women and younger people can also develop it. It is more common in people with a family history, or with conditions like diabetes.

Symptoms

Common symptoms

• A small, painless lump or nodule in your palm.
• Puckering or dimpling of the skin on your palm.
• A thickened cord or band under the skin.
• One or more fingers slowly bending toward your palm, usually the ring or little finger.

Symptoms in children

• Dupuytren contracture is very rare in children, but if it does occur, the symptoms are similar to adults—a thickening in the palm and finger bending.

Symptoms in older adults

• The same symptoms as listed above, but the contracture may progress more slowly in older adults.

Causes

Main causes

• The exact cause is not fully understood. It involves the thickening and tightening of the palmar fascia, a layer of tissue under the skin of your palm.
• Genetics play a role—it often runs in families.

Risk factors

• Being male and over 50 years old.
• Having Northern European ancestry.
• A family history of Dupuytren contracture.
• Diabetes.
• Smoking.
• Drinking large amounts of alcohol.

When to see a doctor

See a doctor urgently if:

• If you suddenly cannot move your fingers or have severe pain after an injury, seek immediate care.

Book a routine appointment if:

• If you notice a lump or nodule in your palm.
• If your finger begins to bend toward your palm and makes it hard to do daily tasks.

Diagnosis

A healthcare provider can usually diagnose Dupuytren contracture during a physical exam. They will feel your palm for thickened tissue or cords and ask you to try to straighten your fingers.

Tests that may be done

• No special tests or imaging are usually needed. The diagnosis is based on the physical exam and your medical history.

What to expect at your appointment

Your doctor will examine your hand and may ask about any family history. If the contracture is more advanced, they may refer you to a hand specialist for further evaluation.

Treatment

Treatment depends on how much the contracture affects your daily life. Mild cases may not need any treatment. For cases that limit hand function, several options are available to help straighten the finger.

Self-care at home

• Gentle stretching exercises to keep the fingers as straight as possible.
• Applying moisturizer to keep the palm skin soft.
• Using tools with larger grips to make daily tasks easier.
• Avoiding smoking and limiting alcohol.

Medical treatments

If needed, your hand specialist may offer treatments such as an injection of a medicine that helps break down the thickened tissue (collagenase injection) or a needle procedure called aponeurotomy to release the tight cord. Both are done in the clinic. In more advanced cases, surgery may be recommended to remove the thickened tissue.

When is surgery considered?

Surgery is usually considered when the finger is bent enough to interfere with daily activities—for example, if you cannot wash your hand, put on gloves, or hold large objects.

Living with this condition

Most people with mild Dupuytren contracture can do all their usual activities. For more affected hands, you might need to adjust how you grip objects, use your other hand more, or try assistive tools.

Lifestyle tips

• Avoid activities that put repeated pressure on your palm, if possible.
• If you smoke, try to quit—smoking may worsen the condition.
• Keep your hand warm and moisturized.

Diet and exercise

A balanced diet is always good for your health, but there is no special diet for Dupuytren contracture. Gentle hand exercises (like making a fist and stretching your fingers) can help maintain flexibility.

Mental health and emotional wellbeing

Living with a hand deformity can affect your self-esteem and how you feel about your appearance. It's normal to feel frustrated or self-conscious. Talking to a counselor or joining a support group can help.

Prevention

There is no known way to prevent Dupuytren contracture. However, avoiding smoking and managing conditions like diabetes may reduce your risk or slow its progress.

Complications

If left untreated

• The finger may become permanently bent and difficult to straighten.
• You might have trouble washing your hand or cleaning between fingers.
• In rare cases, the contracture can cause pain or discomfort in the hand.

Long-term outlook

Dupuytren contracture is not life-threatening. For many people, it stays mild and never needs treatment. Even when it advances, treatments today are very effective at improving hand function and appearance. Most people recover well after treatment and can use their hand normally again.

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