Dupuytren’s Contracture

Dupuytren’s contracture is when the connective tissue in the palm thickens, usually first forming a nodule (a small, hard lump about 0.5-1cm) under the skin of the palm. The nodule sometimes feels tender, to begin with, but this usually passes. More than one nodule may then develop and they are not life-threatening.

Over time, the nodules can extend and form cords of tissue. These cords can shorten (contract) and, if the cords run along a finger or thumb, they can pull it, so it becomes bent towards the palm. These contractures are usually mild and painless, but they can get steadily worse over time. At this point, you may be referred to a hand surgeon to help you.

Physiotherapy cannot help this when there are established contractures and ‘Surgical excision remains the most common treatment.’  However, it is very important post-surgery to help you regain your range of movement and to custom-make nighttime resting splints. A standard protocol for postoperative management of Dupuytren disease, developed by Engstrand et al. in 2009. This is discussed in Physiopedia and found at the Journal of Hand Therapy.