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