Dupuytren's Disease - Treatment Overview

Treatment Overview

The goal of treatment for Dupuytren's disease is to maintain or restore hand function. Dupuytren's disease often is a progressive disease, and recurrence is common. As you review your treatment options, consider the following:

• In the early stages of the disease, you may be able to maintain hand function with physical therapy and range-of-motion exercises.
• If you experience increasing disability or pain in your hand(s), your health professional may give you an injection of lidocaine, corticosteroid, or other medication. However, while medications may be used to treat symptoms, they do not cure or stop the progression of the disease.
• If disability continues to progress, you may choose to have surgery to release the contracture of your fingers. A sustained program of physical therapy and hand exercises may help you regain mobility after surgery. Dupuytren's disease recurs after surgery nearly half of the time, so reoperation may be necessary to maintain hand function.³
• Alternative treatments, such as traction devices or exercises, may be used in conjunction with surgery to treat Dupuytren's disease.

Initial treatment

Dupuytren's disease often develops slowly. If the tissue between your skin and tendons (palmar fascia) does not thicken to the point that your fingers are bent and cannot be straightened (contracture), you may only need to have your palms checked regularly.

Medications are not generally used as part of treatment for Dupuytren's disease. However, long-acting corticosteroid medication is sometimes injected directly into the affected area to help manage symptoms of the disease in its early stages, before one or more fingers develop contracture. This medication may also temporarily help improve function of the hand.

Ongoing treatment

Treatment for Dupuytren's disease depends upon the severity of the disease. You may notice the characteristic nodules in your palms years before you find your condition interfering with daily activities, or you may never have a reduction in your range of motion.

A long-acting corticosteroid medication is sometimes injected directly into the affected area to help manage symptoms of the disease in its early stages, before one or more fingers bends toward the palm (contracture). Medications under study for relief of Dupuytren's disease include interferon and collagenase.³

Treatment if the condition gets worse

In severe Dupuytren's disease, the tissue between your skin and tendons (palmar fascia) thickens to the point that your fingers are bent and cannot be straightened (contracture). If you lose the ability to wear gloves or hold objects, or if your hands become painful, surgery may be done to relieve the contracture. A skin graft may be done after surgery to cover open areas in the palm.

Surgery can be effective at restoring mobility to your hands, but Dupuytren's disease recurs often and reoperation may be necessary to maintain hand function. After surgery, a sustained program of physical therapy and hand exercises may help you regain mobility and prevent complications or recurrences of the disease.³

Should I have surgery for Dupuytren's disease?

What to think about

Splints sometimes are used after surgery for about 8 to 10 weeks to help restore hand function and prevent symptoms of Dupuytren's disease from recurring. Splints support the palm and help straighten the finger(s) during the healing process. In some cases, splints are worn only at night, but in others they are worn at all times, except when the wound needs cleaning or during finger exercises. Your health professional will help you learn how and when you wear the splint during recovery.³