Dupuytrens disease

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Patient Information

https://patient.info/bones-joints-muscles/dupuytrens-contracture-leaflet

GP Information

Background Information

  • A benign, progressive fibroproliferative disorder affecting the palm of the hand and fingers.
  • Variable progression rates with severe disease more common in men with strong family history & patients who develop Dupuytren’s disease at an early age.
  • Patients typically complain of painless lumps in the palm or progressive flexion contractures of the fingers, and difficulty with ADLs.
  • Examination may reveal palmar nodules, cords extending towards the fingers and flexion contractures of the fingers.

Investigation Guidelines

  • Dupuytrens disease is a clinical diagnosis and investigations are not required prior to referral.

Management Recommendations

  • For patients with new disease or slowly progressive disease without significant loss of hand function.
  • No treatment required.
  • Reassure that tender nodules will become less tender over time (typically 6 weeks after 1st appearing).
  • Advise the person to return when they cannot flatten their outstretched hand on a table top or when hand function is compromised.
  • There is no current evidence to support splinting, stretching or steroid injection.
  • For patients whose hand function is significantly compromised or for PIPJ contractures >30 degrees:
  • Refer for discussion of treatment options