Expert Treatment for Dupuytren's Contracture and Finger Contractures

When your fingers begin to curl inward and resist straightening, everyday tasks like buttoning a shirt, shaking hands, and typing become frustrating reminders of what you’ve lost. For many patients, Dupuytren's contracture is more than a hand condition; it’s a loss of independence. Our team at The Center for Hand and Upper Extremity Surgery specializes in turning that around.

Whether you’re newly diagnosed, dealing with advanced contractures, or recovering from a failed surgery, our expert surgeons offer advanced solutions rooted in microsurgical precision and a deep understanding of hand function. This is where patients come when others say, “There’s nothing more we can do.”

Understanding Dupuytren's Contracture

What Is Dupuytren’s Contracture?

Dupuytren’s contracture is a progressive, genetic condition affecting the connective tissue beneath the skin of the palm. Over time, this tissue thickens and forms rope-like cords that can pull the fingers into a bent position, making it difficult or impossible to fully extend them.

This condition most commonly affects the ring and little fingers, and can involve one or both hands. It may also affect the palm and, in some cases, the thumb.

How Dupuytren’s Contracture Progresses

• Dupuytren’s contracture often begins subtly, with small, firm nodules forming in the palm that may go unnoticed at first. You may even notice thickened callouses over the top of your knuckles as well (called “Knuckle Pads”).
• Over time, these nodules thicken and develop into fibrous cords beneath the skin, gradually tightening and pulling on the fingers.
• As the condition advances, these cords cause the fingers to flex and curl, leading to contractures that limit extension and make it difficult to open your hand or lay your hand flat on a surface.

Without surgery, Dupuytren’s contracture does not reverse and often worsens over time. It is a progressive disease. What starts as mild tightness can progress to permanent finger curling and severe loss of hand function.

Signs and Symptoms of Dupuytren's Contracture

Early Stage Symptoms

• Small, firm nodules in the palm
• Skin puckering or dimpling
• Mild tightness when extending fingers
  
  

Progressive Stage Symptoms

• Development of visible cords
• Limited finger straightening
• Gradual increase in stiffness or loss of dexterity
  
  

Advanced Stage Symptoms

• Permanent contracture of one or more fingers
• Interference with hand use (e.g., gripping, typing, washing hands)
• Psychological frustration due to functional decline
  
  

Functional Impact Assessment

At our center, every patient begins with a detailed evaluation that goes beyond the visible contracture. We assess how the condition is affecting your daily activities, hand strength, grip, range of motion, and overall quality of life. This functional impact assessment helps us understand the physical limitations caused by Dupuytren’s disease and how they affect your independence, work, hobbies, and personal goals.

Surgical success for us is about helping you regain the ability to live, work, and engage confidently in the things that matter most to you. This evaluation forms the foundation of your personalized treatment plan and guides our decisions throughout your care journey.

Advanced Dupuytren’s Contracture Treatment at The Center for Hand and Upper Extremity Surgery

Our renowned hand surgeons specialize in treating complex, recurrent, and aggressive forms of Dupuytren’s disease. Whether you’re seeking first-line surgical care or revision after failed treatment, we offer a full spectrum of solutions:

• Microsurgical techniques for advanced and recurrent cases
• Salvage procedures after previous complications or partial surgeries
• Treatment for rare, bilateral, or rapidly progressing disease
• Functional assessments that guide personalized surgical planning
• Multidisciplinary review of prior treatments and outcomes
• Evaluation for related issues, including nerve entrapment or joint stiffness

Every treatment plan is custom-built to match your condition, history, and functional goals.

Surgical Treatment Options

Complete Fasciectomy

This procedure involves carefully removing the thickened fascial cords to release the contracture while preserving the surrounding tissues. It is ideal for moderate-to-severe cases where function is already compromised.

Complete Fasciectomy + Skin Grafting

For patients with dense, extensive fibrosis or skin involvement, we perform complete excision of diseased tissue and may opt for full-thickness skin graft reconstruction to restore both movement and aesthetics. This is reserved for severe cases.

Revision Surgery

Failed or incomplete past treatments don’t mean you’re out of options. Our surgeons perform complex revision procedures to address scar tissue, recurrence, or complications from prior surgeries.

Minimally Invasive Option: Xiaflex Injections

In early-stage, isolated cases, we may consider Xiaflex Injections, a collagenase injected along the cords, specifically designed to target the collagen that forms the cords without damaging the surrounding tissues. This is followed by an in-office procedure to manipulate the fingers and break the cords. While this option may not be as effective as surgical excision, it can be a useful strategy in early-stage disease.

When Surgery is Recommended

When deciding on the best procedure for your condition, we consider your lifestyle, goals, age, occupation, and recurrence risk before recommending surgery. Every case is different, and our approach reflects that. Surgery is generally indicated when:

• Fingers cannot fully straighten
• Function is compromised (e.g., grip, fine motor tasks)
• The condition is progressing rapidly
• Quality of life is affected

There is an easy and reliable way to find out if it’s time to be evaluated by a hand surgeon. Place your hand flat onto a tabletop. If you are unable to get your hand to lie flat because your fingers cannot fully straighten, it’s time for a consultation to discuss your options.

Timing and Expectations

Earlier intervention can reduce the extent of contracture and improve outcomes. We walk every patient through:

• Realistic surgical goals
• Recovery expectations
• Recurrence risk and prevention strategies

Recovery and Rehabilitation Process

Immediate Postoperative Care

After surgery, patients are fitted with a custom splint to support healing and maintain finger alignment. Pain management is tailored individually, often in collaboration with our interventional pain specialists, to ensure comfort during the early recovery phase.

Hand Therapy Program

Rehabilitation begins early with a structured hand therapy program designed to restore range of motion, improve flexibility, and promote scar healing. Therapists guide patients through targeted exercises, scar management techniques, and functional retraining. As healing progresses, therapy focuses on strengthening and helping patients regain confidence in daily hand use.

Long-Term Management

Recovery doesn’t stop at therapy. Patients receive long-term follow-up to monitor for signs of recurrence and ensure lasting improvement. Our team provides ongoing education on hand care, prevention strategies, and support for those managing chronic or recurring forms of Dupuytren’s disease.

Why Choose The Center for Hand and Upper Extremity for Dupuytren's Surgery

Choosing a hand surgeon isn’t just about skill; it’s about finding a team that specializes in your exact condition, and that sees possibilities where others see limitations.

Here’s what sets us apart:

• Access to surgeons who are highly skilled in hand, plastic, and microsurgery
• Extensive experience treating primary and revision Dupuytren’s contracture
• Microsurgical training for the most challenging and recurrent cases
• Advanced reconstructive techniques, including full-thickness skin grafting
• Minimally invasive and revision options not widely available elsewhere
• Team-based care, including hand therapy and pain specialists
• Emphasis on preserving both function and appearance
• Multiple convenient locations in New Jersey
• Online scheduling for fast access to care