About Dupuytren's contracture
Just under the skin of the palm is a layer of tissue called the palmar fascia. In Dupuytren's contracture, this tissue thickens into nodules and then into firm cords that run toward the fingers. Over months to years, the cords tighten and pull the fingers down into a bent position.
It is usually painless, and it most often affects the ring and small fingers. Many people first notice it when they cannot lay the hand flat on a table or when the fingers catch when putting on gloves or reaching into a pocket.
Dupuytren's is a lifelong tendency rather than an injury, so it can progress or return after treatment. The goal of care is to keep the hand working well for daily life, work, and sports.
Common symptoms
- Firm lumps or pits in the palm
- Cords running from the palm toward the fingers
- Fingers, usually the ring and small fingers, that cannot fully straighten
- Trouble laying the hand flat, shaking hands, or putting on gloves
Common causes and risk factors
- Family history, especially Northern European ancestry
- Age, with most people noticing it after midlife
- Male sex, although women can be affected too
- Diabetes, smoking, and heavy alcohol use
How we diagnose it
Dr. Chen examines the palm and measures how far each finger can straighten. A simple check is whether you can lay your hand flat on a table. Ultrasound at the exam table maps the cords and shows how close they sit to the nerves and tendons, which is important for planning a safe needle release.
How Propel treats Dupuytren's contracture
Early nodules without a bent finger usually need only monitoring, since treatment does not prevent progression. Once a finger begins to bend enough to get in the way of daily tasks, it is reasonable to consider a release.
Dr. Chen offers percutaneous Dupuytren's release, in which a needle is used to weaken and divide the tight cord in several spots so the finger can be gently straightened. It is done in the office, with a quick return to hand use. Because the condition can recur, some people need a repeat release later, and complex or severe cases may be referred to a hand surgeon.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about Dupuytren's contracture
- Is Dupuytren's contracture painful?
- Usually not. The nodules can be tender early on, but most people are bothered by the loss of finger straightening rather than pain. Pain in the palm may point to another problem, such as trigger finger.
- When should I get treatment for Dupuytren's contracture?
- A common guide is when you can no longer lay your hand flat on a table or the bent finger gets in the way of daily tasks. Waiting until a joint is severely bent can make it harder to straighten fully. We track your fingers over time so you can decide at the right moment.
- Will Dupuytren's come back after a needle release?
- It can, because the underlying tendency remains. If it returns, a repeat needle release is often possible. We talk openly about what to expect for your hand.