Dupuytren's disease
Information for patients from the Orthopaedic Hand Service
This leaflet explains the following.
What Dupuytren's disease is.
How the condition is diagnosed and treated.
If surgery is an option, what surgery is available.
What the risks and complications of surgery are.
What happens after surgery.
We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to a member of your healthcare team.
What is Dupuytren’s disease and Dupuytren's contracture?
Dupuytren’s disease is a condition that affects the hands and fingers.
Dupuytren’s disease happens when a small lump of tissue develops in the connective tissue of the palm. The lump usually develops where your ring and small fingers meet.
Over time the lump can develop into a fibrous rope like cord, connecting your palm to one or more of your fingers. As this happens your finger pulls down, making it difficult to fully straighten your finger. This condition is known as a Dupuytren’s contracture.
Dupuytren's most commonly affects the little and ring fingers. However, it can affect any finger, and it can develop in both hands. Some people may have nodules on the back of the finger knuckles (Garrod’s knuckle pads) but this is less common.
Dupuytren’s disease does not usually cause pain. When pain does occur, it is often early in the disease and usually settles with time.
It is not a life threatening condition. However, it can cause problems if you try to do certain daily activities. These include putting your hand into a pocket or putting gloves on.
Symptoms are often mild and do not need treatment. However, if it does get worse, we can offer treatment. Progression is usually slow, over months and years.
What causes Dupuytren’s disease?
Dupuytren’s disease is a fairly common condition. It tends to affect more men than women, and often happens later in life. It can affect up to two in every 10 men who are over 60 years of age, and two in every 10 women who are over 80 years of age.
Dupuytren’s disease is most commonly found in white Europeans. It mainly runs in families. The exact cause is unknown, but other factors linked to the condition include:
heavy drinking
smoking
diabetes
In most people with Dupuytren’s disease there is no known cause, or linked illness or injury. It is not due to your type of job, vibrating tools, manual work, or other working environments. Sometimes it may appear after injury or surgery to the hand or wrist.
How is Dupuytren’s disease diagnosed?
Dupuytren’s disease may be difficult to diagnose in its early stages. Most people do not see a health professional until the disease has progressed.
A medical history and physical examination can give enough information for your health professional to diagnose Dupuytren’s disease.
How is it treated?
Many people with Dupuytren’s disease do not need any treatment. Often the condition remains mild. It causes little interference with the use of their hand. There may only be thickened tissue, or thickened tissue with a mild contracture. In these cases, no treatment is usually advised.
There is minimal evidence to show the following have any benefit on reducing the development of a contracture.
Exercise
Splinting
Medications
Radiotherapy
Will I need surgery?
You may need surgery if the condition affects the normal workings of your hand, or is likely to soon.
The goal of surgery is to maintain or restore hand function. Surgery does this by relieving the contracture in your fingers.
However, surgery is still not a cure for the disease. It is common for Dupuytren’s disease to reoccur, but this may take many years.
What surgery is available?
There are several surgeries available that vary in complexity and complications. Your choice of procedure depends on the presentation of the disease in each of your hands.
Partial fasciectomy
A partial fasciectomy is the most common surgery carried out for Dupuytren’s contracture in East Kent. It involves the removal of the abnormal thick and fibrous tissue in your palm and along your fingers. It does this through a ‘zig zag’ cut. This surgery usually gives relief from contracture. It allows you to move your fingers again.
If your palm skin has become stuck (adhered) to the abnormal tissue, we may remove the skin along with the tissue. If we do this, you will have a small skin graft (a dermofasciectomy).
We carry out a fasciectomy in the Day Surgery unit. The operation is usually performed while you are awake. We use a regional anaesthetic, that numbs the affected arm. We may give some patients a general anaesthetic, where you are asleep for the operation.
Local anaesthetic is often injected around the cut at the end of the operation. This may mean that the area and some of your fingers will remain numb for many hours after your surgery.
Needle aponeurotomy
During a needle aponeurotomy your surgeon pushes a fine needle through your skin, over the contracted cord. Your surgeon uses the sharp bevel of the needle to cut the thickened tissue under your skin.
This procedure is done under local anaesthetic (the area is numbed but you are awake).
It is more likely that Dupuytren’s will return following a needle aponeurotomy. To get the best outcome, we select the patients having this treatment carefully.
Needle aponeurotomy can be suitable:
for older patients who are unsuitable for surgery; or
if the contracture is only affecting the knuckle joint.
Your surgeon will tell you if this procedure is an option for you.
What are the risks and possible complications from surgery?
As with any surgery, complications can happen. However, with Dupuytren’s contracture they tend to be quite mild.
For needle aponeurotomy, the complication rate is low (around one in every 100 patients).
For partial fasciectomy, the complication rate is higher (around five in every 100 patients).
Possible complications
After surgery it may not be possible to fully straighten your finger. Particularly if your finger has been bent for many years.
A small number of patients will develop an infection after surgery. You may need antibiotics or a wash out procedure (more common in patients with diabetes).
After injuries and surgery, non-smokers are less likely than smokers to have complications with:
tissue healing; and
infections.
For free friendly support and medication to help you stop smoking, contact One You Kent on telephone 03001 231 220, or email.
Collection of blood or blood clots in the hand tissues (haematoma). This may need a second surgical procedure to remove the blood clot.
Damage to the skin, after trying to surgically separate the skin from the diseased tissue. It may take a little longer for the wound to heal, or the patient may need a skin graft during their procedure.
Dupuytren’s disease can come back and affect other fingers. Most patients will not need further surgery to an already operated finger.
Complex regional pain syndrome (CRPS) is a rare condition. It can cause severe pain, swelling, and stiffness in the hand. It can take several months to improve or may even continue. For more information, please read the CRPS leaflet.
Remember, most patients have an uncomplicated operation with good recovery and outcomes.
What happens if I choose not to have surgery?
If you choose not to have surgery, there is a possibility the contracture may continue to develop. It could pull your finger(s) closer to your palm. This may make it harder to use your hand for daily activities. However, in some cases the contracture does not change.
If your finger is very contracted, the surgical release becomes more challenging. You may not get a completely straight finger if you choose to have surgery at a later date.
How do I care for my hand after surgery?
After surgery, we will bandage your hand with a well-padded dressing. You must keep this dressing dry.
If you had a partial fasciectomy or dermofasciectomy, keep your surgical dressings in place until your first therapy appointment.
If you had a needle aponeurotomy, your surgeon will advise you how long to leave the dressing on for.
It is important to keep your hand elevated (raised) as much as possible to reduce the swelling.
You may have dissolvable stitches that dissolve on their own. If you have non-dissolvable stitches, your GP, therapist or consultant will remove these 10 to 14 days after your surgery. We will tell you which stitches you have after your surgery.
Will I need a follow-up appointment?
Needle aponeurotomy
If you have a needle aponeurotomy you will not usually need a follow-up appointment. The surgical wounds will heal quickly. Your surgeon will tell you how long to leave the dressing on.
We will give you a leaflet with the contact details for a Patient Initiated Follow-Up (PIFU).
Most people are able to get their fingers moving quickly. They are back to using their hand as normal without any follow-up appointments.
Partial fasciectomy
If you have a fasciectomy you will need a follow-up appointment with the Hand Therapy Service. This appointment will be around three to seven days after your surgery. At this appointment a therapist will remove your dressings and check your wound. The therapist will give you exercises and tell you what activities you can use your hand for.
Some patients need a removable splint to protect their operated fingers (see image). Most patients wear this during the day for about two weeks, and at night for several months after surgery. Your therapist will tell you if you need to wear a splint.
If you have had a dermofasciectomy, your therapy will not begin until seven to 14 days after your surgery.
You may need therapy for at least six weeks. This depends on how quickly your wound heals and how quickly normal movement returns in your hand. It is important to remember that your therapist is only there to guide you; it is up to you to do most of the work.
How soon after surgery can I drive?
You can start driving when you can control your car safely and you are no longer wearing the splint during the day. This is usually about two to three weeks after surgery.
Skin grafts take a little longer to heal and need some extra protection in the early stages of healing. So, if you had a dermofasciectomy, you might need to wait longer before driving again. Your therapist will tell you when you can drive again.
When can I return to work?
Return to work depends on the type of work you do.
Someone who does heavy manual work may not be able to return for six weeks after having a skin graft.
An office worker may be able to return to light duties a few days after surgery.
The same applies to sport and the type of sport you play. For advice, please speak to your consultant or therapist.
Further information
East Kent Hospitals. Complex Regional Pain Syndrome (CRPS) patient leaflet.
East Kent Hospitals. Patient Initiated Follow-Up (PIFU) (Orthopaedic Hand Service) patient leaflet.
[Web sites last accessed 18 February 2026]
References
[Web sites last accessed 25 February 2026]
What if I have any questions or concerns
If you have any questions regarding your diagnosis or surgery, please contact your consultant or therapist.
Ask 3 Questions
There may be choices to make about your healthcare. Before making any decisions, make sure you get the answers to these three questions:
What are my choices?
What is good and bad about each choice?
How do I get support to help me make a decision that is right for me?
Your healthcare team needs you to tell them what is important to you. It’s all about shared decision making.
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We have used the terms 'men' and ‘women’ in this leaflet. When we use these terms we also mean people with male or female reproductive organs who do not identify as a man or woman. East Kent Hospitals is committed to supporting people of all gender identities. Please tell your doctor or therapist how you would like them to address you, so we can be sure to get this right.