Dupuytren’s Contracture is a progressive flexion deformity of the fingers, typically affecting the 4th (ring) finger. Also commonly affects the little finger, and rarely the middle finger. It is a result of contracture and fibrosis of the palmar aponeurosis.

It is usually painless, and can affect one or both hands.


  • More common in men (10:1)
  • Increases after age 45
  • Tends only to affect those of Scandinavian and Northern European origin, as well as those from the Iberian peninsula and Japan.


  • It is believed that in about 70% of cases it is the result of a genetic disorder whereby susceptible individuals who are subsequently exposed to further risk factors.  These factors can include:
  • It can also be ideopathic


  • Often a tender nodule on the palm is the first sign
  • Deformity is progressive and follows later
  • Pain subsides as it progresses
  • Eventually the whole hand becomes arched, and there is contracture of the MCP and interphalangeal joints


  • Steroid Injections are useful in early presentations of a tender nodule, and can prevent the formation of the contracture
  • Surgery is indicated if:
    • The hand can’t be placed flat on a flat surface
    • There is contracture of the PIP joints
  • Surgery involves careful removal of the affected palmar aponeurosis around neurovascular bundles (which are left behind). Recurrence can occur particularly if the dissection for removal is not adequate, and/or commonly if the patient is young at the time of surgery
  • Injected collagenase – is a new treatment that has been shown to reverse contracture in some patients but is not widely used.
Dupuytrens Contracture Dupuytren’s Contracture Post Surgery
Dupuytren's Contracture Dupuytren's Contracure after surgery


Related entries