Dupuytren’s Contracture


  • Curling down of the fingers into the palm due to cords of fibrous tissue


  • Cords of fibrous tissue form beneath the skin and they track down into the fingers causing contractures to develop.
  • There is usually a strong family history and people tend to come from Celtic ancestry


  • Usually the contractures are obviously caused by cords of tissue and simple examination of the hand will confirm the diagnosis of Dupuytren’s
  • A positive family history is usually obtained.
  • The patients have difficulty washing their face due to the contracture, difficulty placing their hands in their pockets and usually unable to get their hand flat on the table.


  • Mainstay of treatment is surgical
  • Under general anaesthetic
  • Usually done as a day stay procedure
  • Skin incisions are made over the palpable cords and the diseased tissue is removed.
  • ‘Z’ plasties are performed to break up the line of the scar
  • Occasionally skin grafts are required to replace contracted skin

Needle aponeurotomy can be performed for mild cases in the palm, usually done under sedation in a sterile operating theatre.

Collagenase injections are being trialled overseas and are likely to be available in New Zealand within the next one to two years; however their use remains restricted to predominantly palmar disease.

Potential Complications

  • Infection, haematoma, neurovascular injury, post-operative stiffness, recurrence of contracture
  • In revision cases, amputation of the digit may be required.

Post Op Care

  • Patient is discharged in a plaster slab, keeping the fingers in extension for the first few days
  • Referral to hand therapy for active mobilisation, + or – splinting for up to three months.
  • Wounds are reviewed at ten days and usually dissolving stitches are utilized, so not necessary to be removed.
  • Scarring in the hand softens between three to six months post operatively.
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