Dupuytren’s Contracture: What It Is and How We Treat It

Dupuytren’s contracture is a hand condition that can slowly limit finger motion over time. Dr. Todd Pitts explains what causes this skin-based condition, how it’s different from tendon problems, and what treatment options—from enzyme injections to surgery—can help restore movement and relieve tension.

What Is Dupuytren’s Contracture?

Dupuytren’s contracture is a hand condition that can slowly limit finger motion over time. Dr. Todd Pitts explains what causes this skin-based condition, how it’s different from tendon problems, and what treatment options—from enzyme injections to surgery—can help restore movement and relieve tension. Unlike tendon injuries, Dupuytren’s contracture is a skin and connective tissue disorder, not a problem with the tendons or muscles.

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- Genetics play a large role. It tends to run in families, especially of Northern European descent.
- Over time, the fascia forms nodules and cords under the skin that can slowly tighten.
- These cords can develop mild to severe contractures in the fingers, especially the ring and pinky fingers.
Non-Surgical Approaches
- Bracing: Used early on to slow progression, especially at night.
- Xiaflex Injection (Collagenase Enzyme):
  A minimally invasive injection that breaks down the cord’s collagen. After 48–72 hours, we manipulate the hand to release the contracted cord, restoring finger motion without the need for open surgery.
Surgical Treatment
- For advanced or recurring cases, we may perform a fasciectomy, where the cord is surgically removed through a zig-zag incision.
- While effective, this creates new scarring and may require a longer recovery process.
Whether through injection or surgery, you’ll likely work with a hand therapist to regain range of motion. Some patients may have lingering joint stiffness if the contracture was longstanding, but early treatment improves outcomes.