Dupuytren's contracture pulls one or more fingers slowly towards the palm until the hand will not lie flat. Surgery removes the thickened cords so the finger straightens, and therapy afterwards holds on to what surgery gained.
Dupuytren's contracture surgery removes or divides the tough cords of tissue in the palm that bend a finger towards the hand. It is offered when the finger can no longer be laid flat on a table and daily tasks suffer. Straightening usually improves a great deal, although the tissue can thicken again over the years, so review matters.
Dupuytren's contracture begins in the fascia, a sheet of tissue lying just under the skin of the palm. Small firm nodules appear first, then thicken into cords running towards one or more fingers. As those cords shorten, the finger is drawn towards the palm and will not straighten, most often the ring and little fingers. Tendons themselves stay healthy, which surprises many people.
Treatment is guided by function rather than appearance. A useful check is whether the hand can be laid flat on a table. Once that becomes impossible, or washing the face, wearing gloves and reaching into a pocket become awkward, surgery is discussed. The operation removes the diseased cord through a zigzag incision, freeing the finger while protecting the nerves and vessels that run alongside it.
Skin sometimes has to be rearranged or grafted where a cord was tightly attached underneath. Afterwards a splint and hand therapy hold the gain that surgery created, since the finger drifts back easily in the early weeks if nobody works on it.
Surgery is aimed at people whose finger position has begun to interfere with living, not at everyone who has a lump in the palm. Timing is judged on function.
Each cord is traced by feel and the bend at every joint is measured. Your surgeon checks whether the hand lies flat, marks a zigzag incision that respects the palm creases, and explains how much straightening is realistic.
A regional block numbs the arm while you stay awake, and sedation is available if you would rather doze. The arm rests on a side table with a tourniquet, so fine structures stay clearly visible.
Skin is lifted carefully and the diseased tissue is taken out along its length. Digital nerves and vessels lie stuck to these cords, so they are freed millimetre by millimetre under magnification.
Once the cord has gone the finger is eased straight and any tight joint capsule is released. Skin is then closed, and a graft is used where cover is short after the finger opens out.
A splint holds the finger in its new straightened position, usually for night wear. Your therapist starts guided movement early, because a palm scar tightens quickly when the hand is left still.
Keep the hand raised so the palm does not swell. Dressings stay dry and in place, and pain relief is taken regularly through these first days.
Your dressing is changed and stitches are usually removed at this visit. Hand therapy begins in earnest with straightening and bending exercises, along with a splint to wear at night.
Most of the wound has healed and the scar feels firm to touch. Grip work increases, night splinting often continues, and driving and desk work are usually comfortable again.
Scar softness and movement keep improving. Recovery can vary, and long review matters because cords may thicken again in the same or another finger.
Most people gain useful straightening and find daily tasks easier afterwards. Fingers bent at the middle joint for a long time often keep a little bend, because the joint and skin have shortened as well as the cord. Scar firmness and tingling along the finger can take months to settle. Dupuytren's disease can also return, so the aim is lasting improvement rather than removal for good.
The cords sit right against the nerves and vessels of the finger, so it is worth knowing what these operations involve.
What you do over the first weeks decides how much of the straightening you keep.
Tendons are normal in this condition. Thickened fascia under the skin forms the cord that pulls the finger down, which is why removing that tissue is the treatment.
This condition tends to run in families and is linked with certain medical conditions. Manual work has not been shown to bring it on, although a stiff hand feels worse during heavy use.
Pulling on an established cord does not lengthen it and can irritate the palm. Therapy is valuable after surgery, once the shortened tissue has actually been removed.
Surgery corrects the finger position, yet the underlying tendency remains. Cords can thicken again later, so periodic review is part of the plan rather than a sign of failure.
Elegance Clinic in Surat treats Dupuytren's contracture as a long term condition rather than a single operation. Dr. Ashutosh Shah explains the likely gain, the limits and the therapy commitment before surgery is planned.
Cost depends on how many fingers are involved, how much diseased tissue has to be removed, whether a skin graft is needed and how many therapy sessions are planned. Releasing a single straightforward cord costs less than freeing a finger bent tightly at the middle joint. At Elegance Clinic the estimate is written down after your hand has been examined.
Some insurers accept this operation when function is clearly limited, while others question it, so documentation of the contracture matters. Bring your policy papers to the consultation and the office will help you check the position.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →The figure depends on how many fingers are treated, how tightly they are bent, whether a skin graft is required and how much therapy is planned. You receive a written estimate after examination. Cover differs between insurers, so bring your policy papers along.
It is a planned procedure carried out under magnification, usually with the arm numbed by a block. Nerve injury, slow palm wound healing and stiffness are the main concerns, and each is explained before you decide. Serious problems are uncommon.
Dressings and stitches are dealt with in the first two weeks, then therapy takes over. Light desk work is often possible fairly early, while gripping tools comfortably takes longer. Recovery can vary, and night splinting frequently continues for some months.
Many fingers straighten well, particularly when the bend is mainly at the knuckle. A finger bent at the middle joint for years may keep a little curve, because the joint and skin shortened too. Therapy afterwards protects whatever straightening was achieved.
Yes, it can. The tendency behind the condition stays with you, so a cord may thicken again in the same finger or appear in another. Regular review picks this up early, when treatment choices are wider.
The usual guide is whether the hand still lies flat on a table and whether daily tasks are suffering. Waiting until the finger is tightly curled makes full correction harder, so assessment once the bend appears is sensible.
The palm and each finger are examined, the bend at every joint is measured and the cords are traced by feel. Realistic gains, the therapy plan and the chance of recurrence are all discussed, and a written estimate follows.
Each technique below has its own page explaining how it works and when it is chosen.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
