Dupuytren’s Disease

Dupuytren’s disease affects the palmar fascia, a layer of connective tissue located beneath the skin of the palm. In a healthy hand, this tissue helps support the skin and underlying structures. In Dupuytren’s disease, the fascia becomes abnormal, thickened, and less flexible. Over time, it can form nodules and cords that tighten and shorten.

When the cords progress, they may pull the fingers toward the palm. This is known as Dupuytren’s contracture. The ring finger and small finger are most commonly affected, but the middle finger, index finger, thumb, or multiple fingers can also be involved. One hand may be affected more than the other, although the condition can occur in both hands.

The disease usually develops slowly. Early signs may include a small, firm nodule in the palm or a feeling of tightness under the skin. Some patients experience tenderness at first, although Dupuytren’s disease is often not painful once it progresses. The main problem is usually loss of motion and difficulty opening the hand.

Because Dupuytren’s disease can vary widely from patient to patient, an individualized evaluation is important. Some patients only need monitoring. Others may benefit from treatment once the finger begins to contract or hand use becomes limited.

Treatment depends on the severity of the disease, the degree of finger contracture, the location of the cords, the patient’s overall health, and how much the condition affects hand function. The right treatment plan is individualized.

• Observation: Mild disease may be monitored if finger extension is not significantly limited.
• Minimally invasive treatment: Certain patients may be candidates for less invasive approaches depending on cord location and severity.
• Surgical release or fasciectomy: Surgery may be recommended when thickened tissue significantly limits finger extension and hand function.
• Hand therapy: Therapy may be used after treatment to improve motion, reduce stiffness, and support recovery.
• Splinting: Splinting may be recommended in selected cases after treatment to support finger position during healing.

At New Leaf Plastic & Reconstructive Surgery, treatment is focused on function. A palm nodule alone may not require intervention. A progressive contracture that limits hand opening may be a stronger reason to consider treatment.

Recovery depends on the severity of the condition and the treatment performed. Patients with mild contractures may recover more quickly than patients with advanced disease, multiple fingers involved, or significant joint stiffness.

• Bandage care
• Wound care
• Elevation to reduce swelling
• Splinting when recommended
• Hand therapy or occupational therapy
• Gradual return to hand use
• Monitoring for swelling, stiffness, or wound issues
• Follow-up visits to assess healing and motion

Hand therapy can be an important part of recovery for many patients. Therapy may help improve flexibility, reduce stiffness, guide safe motion, and support functional hand use. Some patients may need exercises to maintain extension and regain strength. Others may require scar management, edema control, or splinting.

Dr. Lovelace will provide detailed recovery instructions based on your procedure. Following these instructions closely can help protect healing tissues and support the best possible functional outcome.