Harvard Women's Health Watch

Ask the doctor: What else can I do for Dupuytren's contracture?

Q. I have Dupuytren's contracture in both hands. I've had "needle" surgery in one hand, and the fingers straightened. But they seem to want to contract again. What can I do?

A. Dupuytren's contracture is a disorder that develops when the palmar fascia — the tissue between the skin and tendons in the palm — thickens and contracts due to an abnormal buildup of collagen, causing one or more fingers (usually the little and ring fingers) to bend inward. Over time, Dupuytren's can make it difficult or impossible to grasp objects, button buttons, use a computer, and perform many other everyday activities. The treatment you mention sounds like needle aponeurotomy (also called percutaneous needle fasciotomy), in which a needle is used to sever the cords that are causing the fingers to contract. Unfortunately, recurrence following treatment is common.

In the early stages of Dupuytren's, treatments include steroid injections to help soften tissues and radiation therapy to slow the disease's progression. The next step has traditionally been needle aponeurotomy, and (if hand function is severely impaired) surgery to remove fascial tissue. (Surgery is a last resort because recovery can be lengthy and there is a risk of complications, such as nerve or artery damage.)

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