This condition is a genetic disease that affects the thick layer of tissue in the palm called the palmar fascia, causing the digits to contract toward the palm. Clients will typically notice the development of a non-tender nodule in their palm, often following an injury or trauma to the hand or wrist. Over time this can develop into a cord-like structure that pulls the digit into a bent position. Once the contracture has formed, the digit can get in the way for tasks like putting on gloves, washing your face or putting your hand in your pocket. Pain is not typically associated with this condition.
The hand therapist’s management for this condition is primarily post-operative education and management. Conservative treatments, such as massage, splinting or exercises, have not been proven to prevent contractures, but may help to delay surgery temporarily.
Common surgical management either involves open surgical excision of the Dupuytren’s tissue, needle release, or collagenase injection, where a special product is injected to dissolve the Dupuytren’s tissue.
There is a relatively high recurrence rate after all these procedures, so night splinting in a custom extension splint (orthosis) is advised. Prescribed exercise is also important to prevent stiffness, and scar management is important to improve flexibility of the thick scar. Sometimes the scar will also require desensitization.
Please note that the information on this page is for reference only and not a substitute for medical advice. If you have a hand injury or condition that requires treatment, please see your physician or hand therapist for an assessment.