Dupuytren’s usually occurs in older men of Northern European descent. This is a contracture deformity, caused by knots and bands of hyper-formed scar tissue, resulting in the fingers unable to be straightened. This condition usually progresses over time and is often non-painful, however can cause restrictions in functional everyday activities such as reaching your hand into your pocket.

• There are no known causes of Dupuytren’s
• Typically, men with Northern European origins are more likely to present with this condition
• No injuries or repetitive occupations are known to cause Dupuytren’s

• Typically a slow progression over years
• Usually begins as a small nodule or knot in the hand and progresses to cords of thickened tissue in the palms of the hand
• As the cords progress, the fingers often contract (bend/flex)
• Typically, the small and ring fingers are the most impacted. The rarest finger involvement is the thumb and index finger
• Can occur in one or both hands

Numerous muscles, ligaments, tendons, and sheaths can be found within the hand. The muscles are the structures that can contract, allowing movement of the bones in the hand. The ligaments are fibrous tissues that help bind together the joints in the hand. The sheaths are tubular structures that surround part of the fingers. The tendons connect muscles in the arm or hand to the bone to allow movement.

• There are no known prevention measures. Night splinting and hand therapy can potentially help

• Typically diagnosed through palpation of the hand and comparing it to the opposite hand to determine if there are tight knots of bands of tissue 
• Doctor or therapist will also measure range of motion and contractures to help determine the best treatment plan

• Dupuytren’s can remain untreated if it is non-painful and does not impact your life and daily occupations significantly
• If it impacts your daily functioning, there are multiple treatment options:
  • Stretching
  • Splinting
  • Needle Aponeurotomy- Needles inserted into the thickened tissue to puncture and break up scar tissue. This often requires multiple rounds of treatment
  • Enzyme injections (Xiaflex)- an enzymatic medication is injected into the cords or thickened tissue to break up the tissue. Typically, 24 hours later, the doctor then numbs the hand and manipulates the contracted fingers to improve range of motion. This may also require multiple rounds of treatment
  • Surgery- There are multiple surgical techniques, however the goal of each is to remove the diseased tissue and increase range of motion of the fingers

• After any of the above treatments, a splint is required with fingers in as straight a position as possible for 48 hours non-stop. Following this around the clock splinting, the splint is transitioned to nighttime only for approximately 1-3 months. 
• Exercises to regain range of motion
• Splinting
• Wound care following surgery
• Strengthening following return of range of motion