Dupuytrens Contracture

Overview

Dupuytren's contracture is a condition that affects the tissue just under the skin of the palm. This tissue slowly becomes thick and tight, like a cord. Over time, it can pull one or more fingers into a bent position that you cannot straighten fully. It is not cancer and is usually not painful, but it can make using your hands harder.

It is fairly common, especially in older adults. Around one in five people over 60 may have some form of it.

It usually appears after age 50 and is more common in men than women. It also tends to run in families.

Symptoms

Common symptoms

• A small, painless lump or nodule in the palm.
• A thick, tight cord under the skin of the palm.
• Difficulty straightening one or more fingers fully.
• A feeling of tightness or discomfort when stretching the hand.

Causes

Main causes

• The exact cause is unknown.
• It involves the connective tissue in the palm thickening and shortening.
• It often runs in families, so genes play a role.

Risk factors

• Age over 60
• Being male
• A family history of Dupuytren's contracture
• Diabetes
• Smoking or heavy alcohol use
• Some health conditions, such as epilepsy

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe pain or loss of hand movement.
• If you see signs of infection, like spreading redness or fever.

Book a routine appointment if:

• If you notice a lump or cord in your palm.
• If you have trouble straightening a finger or holding things.
• If the condition is affecting your daily life.

Diagnosis

A doctor can usually diagnose Dupuytren's contracture by examining your hand. They will feel your palm and fingers and ask you to straighten your fingers. They may also check for signs in your feet.

Tests that may be done

• There are usually no special tests needed.
• In rare cases, an ultrasound or other imaging test may be used to look at the tissue.
• Blood tests are not used to diagnose this condition.

What to expect at your appointment

During your appointment, the doctor will ask about your symptoms, family history, and health conditions. They will examine both hands and may measure how far each finger can straighten. You should get a diagnosis during the visit.

Treatment

Treatment depends on how much the fingering is bent and whether it affects your daily life. Many people do not need any treatment. For others, there are non-surgical options and surgery. Your doctor will discuss the benefits and risks with you.

Self-care at home

• Gently stretch and massage your palm and fingers.
• Warm your hands before activities to make them more flexible.
• Avoid tightly gripping handles or tools. Use padded gloves if needed.
• Keep your hand moving with normal activities, but stop if you feel pain.

Medical treatments

Medical treatments include injections that help soften and break down the thickened tissue, and a procedure called needle fasciotomy, where a fine needle is used to divide the cord. These are done by specialists. Surgery can remove the thickened tissue. There is no specific medication for this condition, but your doctor may recommend pain relief before or after treatment.

When is surgery considered?

Surgery may be considered if the contracture stops you from doing everyday tasks, such as writing, cleaning, or dressing, or if your finger is severely bent. Surgery can help, but it is not always a permanent cure and recovery takes time.

Living with this condition

Living with Dupuytren's contracture means making small adjustments. Try to keep your hand active, avoid injuring your palm, and talk to your healthcare team if the condition changes.

Lifestyle tips

• If you have diabetes, keep your blood sugar well controlled.
• Limit alcohol intake and stop smoking to slow progression.
• Use hand cream to keep the skin soft and flexible.

Diet and exercise

There is no special diet for this condition, but a healthy balanced diet and regular physical activity can support your overall health. Gentle hand exercises may help keep your fingers moving.

Mental health and emotional wellbeing

Having a hand that does not work fully can feel frustrating and may affect your confidence. It is common to worry about the future. Talk to your doctor or a counsellor if you feel anxious or down.

Prevention

There is no proven way to prevent Dupuytren's contracture, because the cause is partly genetic. You can reduce the risk of it getting worse by not smoking and limiting alcohol for heavy drinking.

Complications

If left untreated

• Fingers may become fixed in a bent position, making it hard to use the hand.
• Everyday tasks like holding objects, shaking hands, or putting on gloves may become difficult.

Long-term outlook

Dupuytren's contracture does not affect your overall health or how long you live. Many people live comfortably with it. When treatment is needed, most people see improvement in hand function. With the right help, you can manage the condition and stay active.

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