What Is Dupuytren's Contracture?
Dupuytren's disease is a fibroproliferative disorder of the palmar fascia. Over time, tissue thickens into nodules and cords that progressively pull the fingers into a flexed position — most commonly the ring and little fingers. It is most common in men of Northern European descent over age 50 and has a strong genetic component.
Symptoms
- Firm nodules in the palm
- Cords extending from palm into the finger
- Progressive inability to fully straighten one or more fingers
- Difficulty with tasks requiring an open, flat hand
Treatment Options
Needle Aponeurotomy
A needle is used to perforate and rupture the cord through the skin under local anesthesia in the office — no incision, rapid return to activity. Best for isolated cord disease.
Collagenase Injection (Xiaflex)
An enzyme is injected into the cord, weakening it over 24 hours before rupture at a follow-up visit. FDA-approved and effective for moderate contractures.
Surgical Fasciectomy
For severe or recurrent cases, surgical removal of the diseased fascia provides the most reliable and durable correction. Dr. Richards' plastic surgery training brings expertise in skin management, Z-plasty, and neurovascular handling — critical in advanced cases.