Dupuytren's Contracture

Sometimes also called Dupuytren’s Disease or Viking Hand

Schedule Now With a Hand & Wrist Specialist

With Dupuytren’s contracture, daily activities involving your hands can become very difficult. Fortunately, both surgical and nonsurgical treatment can be effective.

In a healthy hand, fascia helps support the skin, muscles, tendons, nerves and blood vessels. In Dupuytren’s contracture, the fascia becomes abnormal, forming thick cords under the skin.

What Is Dupuytren’s Contracture Disease?

Dupuytren’s contracture is a condition that affects the palm of your hand and fingers. It develops when the fascia, a layer of tissue that stabilizes the skin and underlying structures, thickens and tightens over time. This tightening can pull the fingers toward the palm, making it difficult to fully straighten them and forming thick cords under the skin. These cords may look and feel like tendons, but unlike tendons, they do not move. Nodules, or small lumps, often form in the palm and may gradually develop into cords that pull one or more fingers into a bent position.

The condition typically progresses slowly, but it can vary from person to person. The ring and little fingers are most commonly affected, and one or both hands may be involved.

What are Causes and Risk Factors for Dupuytren’s Contracture?

The exact cause of Dupuytren’s contracture is unknown, but genetics likely play a major role. Factors that may increase risk include:

Gender: Men are more likely than women to develop it
Age: Most common in people over 40
Ancestry: Higher prevalence among Northern European or Scandinavian descent
Family history: Other family members with the condition
Medical conditions: Diabetes, seizure disorders
Lifestyle factors: Alcohol use, lower body mass index

Hand injuries or specific occupations do not seem to directly cause the disease, although trauma may trigger a single nodule in someone already at risk.

What are Signs and Symptoms of Dupuytren’s Contracture?

Dupuytren’s contracture usually starts with small lumps or nodules in the palm. Over time, these may develop into cords that bend the fingers toward the palm. Common signs include:

Contractures: Fingers that cannot fully straighten
Nodules: Firm lumps in the palm
Cords: Dense bands of tissue under the skin
Skin changes: Thickened, puckered, or tethered areas on the palm
Functional difficulties: Trouble placing your hand flat, washing hands, holding objects, wearing gloves or shaking hands

Most people do not experience significant pain, but hand function may become limited as the contracture progresses.

How is Dupuytren’s Contracture Treated?

There is no cure for Dupuytren’s contracture, but treatments can improve finger motion and hand function.

Non-Surgical Treatments

Needle fasciotomy (aponeurotomy): A needle is used to cut the cord beneath the skin, followed by gentle stretching to straighten the fingers. Recovery is typically quick, and the hand can be used as tolerated. Some cords may recur over time.
Collagenase injections: An injectable enzyme dissolves the cord, and the fingers are then stretched to break the cord. Swelling, bruising, and mild pain are common but usually resolve quickly.
Splinting and hand therapy: May be used after non-surgical treatments to maintain finger straightness, improve function, and prevent recurrence.

Surgical Treatments

Surgery is considered if the contracture significantly limits hand function. Options include:

Fasciotomy: Cutting the cord through small incisions
Fasciectomy: Removing the cord, nodules, and diseased tissue

Surgery is outpatient (you’ll go home the same day), but recovery may take several weeks. Hand therapy and splinting after surgery are crucial for regaining motion and function. Even after surgery, cords may recur in some patients.

What is it Like Living With Dupuytren’s Contracture?

Dupuytren’s contracture is not dangerous to overall health, but it can affect hand function and quality of life. Early evaluation and individualized treatment planning with a hand surgeon can help preserve mobility and function.

Regular follow-up and hand exercises may help maintain hand use, even if the disease progresses over time.

Dupuytren’s Contracture Treatment at OrthoNebraska

Need relief from Dupuytren’s contracture in the Omaha area? At OrthoNebraska, we want to make sure that our patients feel understood, safe and confident to take on an appropriate treatment plan. With proper management, we can help you reduce pain levels and improve quality of life.

Schedule Now With a HAND AND WRIST Specialist