Dupuytren's Contracture: Treatment and Surgery

Dupuytren's contracture is a thickening of the fibrous layer beneath the skin of the palm. Over years it forms nodules, then cords, which slowly shorten and pull the fingers, most often the ring and little fingers, toward the palm. It runs strongly in families, particularly those with Northern European ancestry, and is more common in men, with age, in diabetes, and with smoking or heavy alcohol use.

Two honest facts of Dupuytren's Contracture frame everything else. It isn't caused by work or injury, whatever the folklore says, and it can't currently be cured: treatment straightens fingers and restores function, sometimes for many years, but the underlying tendency remains. What good treatment offers is control, timed well.

Needle fasciotomy uses a fine needle, under local anaesthetic, to divide the cord through tiny punctures: minutes long, minimal recovery, excellent for suitable cords in earlier disease. The trade-off is honesty itself: recurrence is more likely and often sooner than after surgery.

Limited fasciectomy, removing the diseased tissue through an incision, is the more durable operation: a day case under local or regional anaesthetic, with a longer recovery (splinting, sometimes hand therapy) but a lower and slower recurrence rate. Severe or recurrent cases may need more involved surgery, discussed openly if that's where you are.

Which rung is right depends on your cord pattern, bend severity, age, hand use and appetite for repeat procedures; the consultation exists to lay those trade-offs out plainly.

Apex Medical was founded by Mr Kuen Yeow Chin, Consultant Plastic Surgeon and Clinical Lead for Plastic Surgery at Frimley Health NHS Foundation Trust. Hand and nerve surgery, including Dupuytren's contracture, carpal tunnel and trigger finger, is one of his defining specialisms, and he is a member of the British Society for Surgery of the Hand (BSSH).

Your consultation, your Dupuytren's Contracture procedure and your follow-up are with the same consultant throughout: the surgeon who assesses your hand is the surgeon who treats it.

Examination maps your cords and measures the bend at each joint; you'll leave knowing your stage and realistic options.

An honest recommendation, including "not yet" for early nodules.

Needle fasciotomy: under 30 minutes, local anaesthetic, dressing for a few days. Fasciectomy: day case, local or regional anaesthetic, hand bandaged and elevated.

Needle: gentle use within days. Surgery: dressings and possibly a night splint for some weeks, early finger exercises, hand therapy where it helps.

Review, straight talk about recurrence risk for your pattern, and a plan for if and when it returns.

After needle fasciotomy, expect small dressings for a few days and gentle use of the hand almost immediately; most people are back to desk work straight away and driving within days. After fasciectomy, the hand is bandaged and elevated at first, with dressings for up to two weeks, early finger exercises from the start, and sometimes a night splint for several weeks. Driving returns when your grip is safe, typically one to two weeks; heavier hand use builds over four to six weeks, with hand therapy where it helps.

Scars in the palm soften and fade over months, and we'll show you how to care for them. Because Dupuytren's Contracture is controlled rather than cured, aftercare also includes straight talk about recurrence: what your pattern suggests, what to watch for, and when to come back if a cord returns.

Apex Medical is based at Berkshire Grove Hospital in Maidenhead, with clinics also at the Parkside Suite.
Patients travel to us from Reading, Windsor, Slough, Marlow, Bracknell, London and across Berkshire, Surrey and Oxfordshire for consultant-led care in a regulated private hospital, without long waiting times. On-site parking is available.

Common questions about Dupuytren's Contracture at Apex Medical