Dupuytren's Contracture — Why Fingers Curl Into the Palm
Dupuytren's contracture is a condition where the tissue in the palm thickens and forms cords that can pull one or more fingers toward the palm. It often progresses slowly over years. It's not caused by typing or using your hands too much, and it isn't a tendon problem — the tendons are normal; the palmar fascia is the issue.
What You May Notice
Firm nodules or cords in the palm, most often under the ring or small finger
Gradual loss of ability to straighten the finger(s)
Usually painless, but function can be limited as the finger bends more
Family history is common; risk increases with age and in some populations
Do You Need Treatment Right Away?
Not always. If the finger is still straight and function is fine, observation is reasonable. Treatment is considered when contracture interferes with daily activities (for example, if you can't place your hand flat on a table, or the finger is starting to curl).
Treatment Options
Needle aponeurotomy (percutaneous release): A fine needle weakens the cord so the finger can be straightened. Minimally invasive; quick recovery.
Enzyme injection (collagenase): Injected into the cord to soften it, then gently straightened in clinic a day or two later.
Surgery (limited fasciectomy or related procedures): Removes the diseased fascia; chosen for more complex or recurrent disease.
No current treatment stops Dupuytren's permanently. Recurrence or progression over the years is possible with any option; the goal is to improve function safely and match the approach to your pattern of disease.
Recovery & Aftercare
Expect hand therapy, stretches, and sometimes a nighttime extension splint after treatment to maintain gains.
Return to light activities is often quick after needle or enzyme procedures; surgery involves a longer recovery but can address more extensive disease.
Bottom Line
If a finger is starting to curl or your palm cords are limiting function, effective options exist — from minimally invasive releases to surgery. A hand surgeon can walk you through the safest approach for your hand.
Frequently Asked Questions
What is Dupuytren's contracture?
A thickening of the palmar fascia (not the tendons) that forms cords in the palm and can pull one or more fingers toward the palm over time.
Does it always need treatment?
No. Observation is reasonable if the finger stays straight and function is good. Treatment is considered when contracture limits hand use.
What treatments are available?
Needle aponeurotomy, collagenase enzyme injection, or surgical fasciectomy—chosen based on pattern and severity.
Will it come back after treatment?
Recurrence or progression can occur with any option. The goal is to improve function safely; choice depends on your disease pattern and goals.
How long is recovery?
Recovery varies by procedure. Minimally invasive options often have quicker return to light use; surgery requires a longer recovery and hand therapy.
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