Dupuytren’s contractureis a condition that causes tight tissue to form in the palm of the hand and fingers. Exactly why this condition occurs is a bit of a mystery, but there is a known genetic component and there have been other factors including lifestyle, activities, and other medical conditions that may also play a part.This tightening of the tissue in the palm, called the fascia, pulls the fingers down into the palm making simple activities difficult—especially as the condition worsens. For this reason, many people with this condition seek treatments to help improve the function of the hand. Different treatments may have different risks.Here are some of the more common complications that can occur fortreatment of Dupuytren’s contracture.
Dupuytren’s contractureis a condition that causes tight tissue to form in the palm of the hand and fingers. Exactly why this condition occurs is a bit of a mystery, but there is a known genetic component and there have been other factors including lifestyle, activities, and other medical conditions that may also play a part.
This tightening of the tissue in the palm, called the fascia, pulls the fingers down into the palm making simple activities difficult—especially as the condition worsens. For this reason, many people with this condition seek treatments to help improve the function of the hand. Different treatments may have different risks.
Here are some of the more common complications that can occur fortreatment of Dupuytren’s contracture.
1RecurrenceWarren_Price/iStockphotoRecurrence of Dupuytren’s is almost a guarantee after treatment for contracture. Dupuytren’s disease is a condition that leads to a contracture developing. Treatment of the symptom (the contracture) does not eradicate the underlying problem (the condition). Therefore, over time, the problem is likely to come back.Current treatments, including surgery, therapy,needle aponeurotomy, andcollagenase injections, are all directed at the symptoms. The average time until a recurrence occurs differs between these treatments—with about 50% of people having a recurrence within three years of needle aponeurotomy and within five years of surgery.Trying to predict the timing, or the severity, of a recurrence is nearly impossible.Research is investigating the biology of Dupuytren’s disease and, over time, we may develop systemic treatments that can alter the course of this disease. One promising treatment being studied is the use of radiotherapy (or radiation therapy) to treat the early stages of the disease and prevent future functional impairment. However, more research is needed to determine its effectiveness.
1
RecurrenceWarren_Price/iStockphotoRecurrence of Dupuytren’s is almost a guarantee after treatment for contracture. Dupuytren’s disease is a condition that leads to a contracture developing. Treatment of the symptom (the contracture) does not eradicate the underlying problem (the condition). Therefore, over time, the problem is likely to come back.Current treatments, including surgery, therapy,needle aponeurotomy, andcollagenase injections, are all directed at the symptoms. The average time until a recurrence occurs differs between these treatments—with about 50% of people having a recurrence within three years of needle aponeurotomy and within five years of surgery.Trying to predict the timing, or the severity, of a recurrence is nearly impossible.Research is investigating the biology of Dupuytren’s disease and, over time, we may develop systemic treatments that can alter the course of this disease. One promising treatment being studied is the use of radiotherapy (or radiation therapy) to treat the early stages of the disease and prevent future functional impairment. However, more research is needed to determine its effectiveness.
Recurrence
Warren_Price/iStockphoto
Recurrence of Dupuytren’s is almost a guarantee after treatment for contracture. Dupuytren’s disease is a condition that leads to a contracture developing. Treatment of the symptom (the contracture) does not eradicate the underlying problem (the condition). Therefore, over time, the problem is likely to come back.
Current treatments, including surgery, therapy,needle aponeurotomy, andcollagenase injections, are all directed at the symptoms. The average time until a recurrence occurs differs between these treatments—with about 50% of people having a recurrence within three years of needle aponeurotomy and within five years of surgery.Trying to predict the timing, or the severity, of a recurrence is nearly impossible.
Research is investigating the biology of Dupuytren’s disease and, over time, we may develop systemic treatments that can alter the course of this disease. One promising treatment being studied is the use of radiotherapy (or radiation therapy) to treat the early stages of the disease and prevent future functional impairment. However, more research is needed to determine its effectiveness.
2
Nerve Injury
Marcela Barsse/Getty Images
3PainADAM GAULT/SPL/GettyImagesPain after treatment is a frustrating problem. In general, Dupuytren’s contracture is an annoying problem, but not a painful problem. However, up to 20 percent of people report significant pain after treatment of the condition.The hand and fingers are full of nerve endings and prone to developing discomfort after treatment. Typically, the pain resolves with time, but there are some people who have chronic pain or a condition calledcomplex regional pain syndromethat can cause ongoing discomfort and disability.Pain after treatment from Dupuytren’s contracture can often be improved with specific therapeutic activities. For many people, working with an occupational therapist or hand therapist can be beneficial. These are individuals who have specific training and helping to restore normal function to the hands and fingers. Because of the complex interaction of joints, tendons, muscles, and other structures, working with someone who has experience and expertise in the function of hands can help people who are struggling with discomfort following treatment of Dupuytren’s contracture.
3
PainADAM GAULT/SPL/GettyImagesPain after treatment is a frustrating problem. In general, Dupuytren’s contracture is an annoying problem, but not a painful problem. However, up to 20 percent of people report significant pain after treatment of the condition.The hand and fingers are full of nerve endings and prone to developing discomfort after treatment. Typically, the pain resolves with time, but there are some people who have chronic pain or a condition calledcomplex regional pain syndromethat can cause ongoing discomfort and disability.Pain after treatment from Dupuytren’s contracture can often be improved with specific therapeutic activities. For many people, working with an occupational therapist or hand therapist can be beneficial. These are individuals who have specific training and helping to restore normal function to the hands and fingers. Because of the complex interaction of joints, tendons, muscles, and other structures, working with someone who has experience and expertise in the function of hands can help people who are struggling with discomfort following treatment of Dupuytren’s contracture.
Pain
ADAM GAULT/SPL/GettyImages
Pain after treatment is a frustrating problem. In general, Dupuytren’s contracture is an annoying problem, but not a painful problem. However, up to 20 percent of people report significant pain after treatment of the condition.
The hand and fingers are full of nerve endings and prone to developing discomfort after treatment. Typically, the pain resolves with time, but there are some people who have chronic pain or a condition calledcomplex regional pain syndromethat can cause ongoing discomfort and disability.
Pain after treatment from Dupuytren’s contracture can often be improved with specific therapeutic activities. For many people, working with an occupational therapist or hand therapist can be beneficial. These are individuals who have specific training and helping to restore normal function to the hands and fingers. Because of the complex interaction of joints, tendons, muscles, and other structures, working with someone who has experience and expertise in the function of hands can help people who are struggling with discomfort following treatment of Dupuytren’s contracture.
4Skin Tearsbojan fatur/Getty ImagesSkin damage is surprisingly common after treatment for Dupuytren’s contracture. When Dupuytren’s contracture pulls the fingers into the palm of the hand, the skin can also tighten and contract.In addition, the skin becomes much less supple and flexible.When a release of the Dupuytren’s cord is performed, the skin may need to be released or it may tear. During surgery, sometimes a skin graft is necessary to close wounds. After collagenase injections or needle aponeurotomy, the skin may tear and holes may open. These openings in the skin can become infected and painful. For this reason, skin tightness may ultimately limit the amount of improvement your healthcare provider can achieve with treatment.
4
Skin Tearsbojan fatur/Getty ImagesSkin damage is surprisingly common after treatment for Dupuytren’s contracture. When Dupuytren’s contracture pulls the fingers into the palm of the hand, the skin can also tighten and contract.In addition, the skin becomes much less supple and flexible.When a release of the Dupuytren’s cord is performed, the skin may need to be released or it may tear. During surgery, sometimes a skin graft is necessary to close wounds. After collagenase injections or needle aponeurotomy, the skin may tear and holes may open. These openings in the skin can become infected and painful. For this reason, skin tightness may ultimately limit the amount of improvement your healthcare provider can achieve with treatment.
Skin Tears
bojan fatur/Getty Images
Skin damage is surprisingly common after treatment for Dupuytren’s contracture. When Dupuytren’s contracture pulls the fingers into the palm of the hand, the skin can also tighten and contract.In addition, the skin becomes much less supple and flexible.
When a release of the Dupuytren’s cord is performed, the skin may need to be released or it may tear. During surgery, sometimes a skin graft is necessary to close wounds. After collagenase injections or needle aponeurotomy, the skin may tear and holes may open. These openings in the skin can become infected and painful. For this reason, skin tightness may ultimately limit the amount of improvement your healthcare provider can achieve with treatment.
5Scar TissueMaximkostenko/iStockphotoScar tissue is a result of any type of invasive treatment. With less invasive treatment, less scar tissue typically forms. With more invasive treatments, more scar tissue can form. Scar tissue is most common after surgical treatment and can ultimately limit future treatment options if and when the contracture returns down the road.One of the frustrating aspects of treatment of Dupuytren’s disease is the fact that Dupuytren’s contracture causes a reaction under the skin that is very similar to the formation of scar tissue.This is one of the major reasons why clinicians are often reluctant to aggressively treat Dupuytren’s. For some people, the treatment can be just as bad, if not worse than, the original problem. The hope with less invasive treatments such as needle aponeurotomy and collagenase injections is that they provide relief without the risk of development of scar tissue.
5
Scar TissueMaximkostenko/iStockphotoScar tissue is a result of any type of invasive treatment. With less invasive treatment, less scar tissue typically forms. With more invasive treatments, more scar tissue can form. Scar tissue is most common after surgical treatment and can ultimately limit future treatment options if and when the contracture returns down the road.One of the frustrating aspects of treatment of Dupuytren’s disease is the fact that Dupuytren’s contracture causes a reaction under the skin that is very similar to the formation of scar tissue.This is one of the major reasons why clinicians are often reluctant to aggressively treat Dupuytren’s. For some people, the treatment can be just as bad, if not worse than, the original problem. The hope with less invasive treatments such as needle aponeurotomy and collagenase injections is that they provide relief without the risk of development of scar tissue.
Scar Tissue
Maximkostenko/iStockphoto
Scar tissue is a result of any type of invasive treatment. With less invasive treatment, less scar tissue typically forms. With more invasive treatments, more scar tissue can form. Scar tissue is most common after surgical treatment and can ultimately limit future treatment options if and when the contracture returns down the road.
One of the frustrating aspects of treatment of Dupuytren’s disease is the fact that Dupuytren’s contracture causes a reaction under the skin that is very similar to the formation of scar tissue.This is one of the major reasons why clinicians are often reluctant to aggressively treat Dupuytren’s. For some people, the treatment can be just as bad, if not worse than, the original problem. The hope with less invasive treatments such as needle aponeurotomy and collagenase injections is that they provide relief without the risk of development of scar tissue.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Scherman P, Jenmalm P, Dahlin LB.Three-year recurrence of Dupuytren’s contracture after needle fasciotomy and collagenase injection: a two-centre randomized controlled trial.J Hand Surg Eur Vol. 2018;43(8):836-840. doi: 10.1177/1753193418786947Denkler KA, Park KM, Alser O.Treatment options for Dupuytren’s disease: tips and tricks.Plast Reconstr Surg Glob Open. 2022;10(1):e4046. Published 2022 Jan 27. doi:10.1097/GOX.0000000000004046Denkler K.Surgical complications associated with fasciectomy for dupuytren’s disease: a 20-year review of the English literature.Eplasty.2010;10:e15.Sanjuan-cerveró R, Carrera-hueso FJ, Vazquez-ferreiro P, Fikri-benbrahim N, Franco-ferrando N, Peimer CA.Pain Associated With Treatment of Dupuytren Contracture With Collagenase Clostridium histolyticum.J Hand Surg Am.2017;42(2):e109-e114. doi:10.1016/j.jhsa.2016.11.032Wade R, Igali L, Figus A.Skin involvement in Dupuytren’s disease.J Hand Surg EurVol. 2016;41(6):600-8. doi:10.1177/1753193415601353Becker GW, Davis TR.The outcome of surgical treatments for primary Dupuytren’s disease–a systematic review.J Hand Surg Eur Vol. 2010;35(8):623-6. doi:10.1177/1753193410376286Additional ReadingBlack EM, Blazar PE. “Dupuytren disease: an evolving understanding of an age-old disease” J Am Acad Orthop Surg. 2011 Dec;19(12):746-57.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Scherman P, Jenmalm P, Dahlin LB.Three-year recurrence of Dupuytren’s contracture after needle fasciotomy and collagenase injection: a two-centre randomized controlled trial.J Hand Surg Eur Vol. 2018;43(8):836-840. doi: 10.1177/1753193418786947Denkler KA, Park KM, Alser O.Treatment options for Dupuytren’s disease: tips and tricks.Plast Reconstr Surg Glob Open. 2022;10(1):e4046. Published 2022 Jan 27. doi:10.1097/GOX.0000000000004046Denkler K.Surgical complications associated with fasciectomy for dupuytren’s disease: a 20-year review of the English literature.Eplasty.2010;10:e15.Sanjuan-cerveró R, Carrera-hueso FJ, Vazquez-ferreiro P, Fikri-benbrahim N, Franco-ferrando N, Peimer CA.Pain Associated With Treatment of Dupuytren Contracture With Collagenase Clostridium histolyticum.J Hand Surg Am.2017;42(2):e109-e114. doi:10.1016/j.jhsa.2016.11.032Wade R, Igali L, Figus A.Skin involvement in Dupuytren’s disease.J Hand Surg EurVol. 2016;41(6):600-8. doi:10.1177/1753193415601353Becker GW, Davis TR.The outcome of surgical treatments for primary Dupuytren’s disease–a systematic review.J Hand Surg Eur Vol. 2010;35(8):623-6. doi:10.1177/1753193410376286Additional ReadingBlack EM, Blazar PE. “Dupuytren disease: an evolving understanding of an age-old disease” J Am Acad Orthop Surg. 2011 Dec;19(12):746-57.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Scherman P, Jenmalm P, Dahlin LB.Three-year recurrence of Dupuytren’s contracture after needle fasciotomy and collagenase injection: a two-centre randomized controlled trial.J Hand Surg Eur Vol. 2018;43(8):836-840. doi: 10.1177/1753193418786947Denkler KA, Park KM, Alser O.Treatment options for Dupuytren’s disease: tips and tricks.Plast Reconstr Surg Glob Open. 2022;10(1):e4046. Published 2022 Jan 27. doi:10.1097/GOX.0000000000004046Denkler K.Surgical complications associated with fasciectomy for dupuytren’s disease: a 20-year review of the English literature.Eplasty.2010;10:e15.Sanjuan-cerveró R, Carrera-hueso FJ, Vazquez-ferreiro P, Fikri-benbrahim N, Franco-ferrando N, Peimer CA.Pain Associated With Treatment of Dupuytren Contracture With Collagenase Clostridium histolyticum.J Hand Surg Am.2017;42(2):e109-e114. doi:10.1016/j.jhsa.2016.11.032Wade R, Igali L, Figus A.Skin involvement in Dupuytren’s disease.J Hand Surg EurVol. 2016;41(6):600-8. doi:10.1177/1753193415601353Becker GW, Davis TR.The outcome of surgical treatments for primary Dupuytren’s disease–a systematic review.J Hand Surg Eur Vol. 2010;35(8):623-6. doi:10.1177/1753193410376286
Scherman P, Jenmalm P, Dahlin LB.Three-year recurrence of Dupuytren’s contracture after needle fasciotomy and collagenase injection: a two-centre randomized controlled trial.J Hand Surg Eur Vol. 2018;43(8):836-840. doi: 10.1177/1753193418786947
Denkler KA, Park KM, Alser O.Treatment options for Dupuytren’s disease: tips and tricks.Plast Reconstr Surg Glob Open. 2022;10(1):e4046. Published 2022 Jan 27. doi:10.1097/GOX.0000000000004046
Denkler K.Surgical complications associated with fasciectomy for dupuytren’s disease: a 20-year review of the English literature.Eplasty.2010;10:e15.
Sanjuan-cerveró R, Carrera-hueso FJ, Vazquez-ferreiro P, Fikri-benbrahim N, Franco-ferrando N, Peimer CA.Pain Associated With Treatment of Dupuytren Contracture With Collagenase Clostridium histolyticum.J Hand Surg Am.2017;42(2):e109-e114. doi:10.1016/j.jhsa.2016.11.032
Wade R, Igali L, Figus A.Skin involvement in Dupuytren’s disease.J Hand Surg EurVol. 2016;41(6):600-8. doi:10.1177/1753193415601353
Becker GW, Davis TR.The outcome of surgical treatments for primary Dupuytren’s disease–a systematic review.J Hand Surg Eur Vol. 2010;35(8):623-6. doi:10.1177/1753193410376286
Black EM, Blazar PE. “Dupuytren disease: an evolving understanding of an age-old disease” J Am Acad Orthop Surg. 2011 Dec;19(12):746-57.
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