PROGRESSIVE PALM CONTRACTURE
Thickened tissue beneath the palm gradually pulls the fingers inward, restricting grip and hand function. Surgical release removes the diseased cords and lets your hand work freely again.
WHAT'S HAPPENING BENEATH THE SKIN
Dupuytren’s Disease affects the fascia — the fibrous layer beneath the skin of the palm. Over time, this tissue thickens, contracts and forms firm cords that extend toward the fingers, gradually drawing them into a bent position you cannot reverse on your own. There is no known cure, but surgery is highly effective at releasing the contracture and restoring function.
Both surgical and non-surgical options exist, though non-surgical approaches carry a significant risk of recurrence and potential nerve injury. Surgery is the most durable treatment — particularly important given how tightly the abnormal cords often intertwine with the nerves that supply the fingers. Precision is essential.
The procedure involves dividing and removing the thickened tissue, freeing the tendons and restoring finger mobility. Where the overlying skin has become too taut, a skin graft may also be required. Outcomes depend on disease severity before surgery, but meaningful improvement in hand function is expected in the great majority of cases — especially with a structured post-operative physiotherapy programme.
NOT EVERYONE IS EQUALLY AT RISK
Dupuytren’s Disease tends to run in families, which is why understanding your risk profile matters. While no single factor guarantees you will develop the condition, several characteristics are consistently associated with a higher rate of disease — and knowing your predisposition allows for earlier assessment if symptoms emerge.
The condition is sometimes referred to as ‘Viking’s disease’ due to its prevalence among people of Northern European ancestry. Risk does not mean inevitability — but if any of the factors listed here apply to you and you notice a thickening in your palm, an early consultation is well worth arranging.
Northern European descent ('Viking's disease')
Male, typically over the age of 40
Family history of Dupuytren's Disease
Type 1 or Type 2 diabetes
Long-term use of anti-epileptic medication
Heavy or long-term alcohol use
Smoking or a history of tobacco use
Previous hand injury or surgery in the affected area
THE PROCEDURE AT A GLANCE
Everything you need to know before you walk through the door.
Surgery Time
Anaesthesia
Hospital Stay
Drains
Supporting Garment
The exact surgical approach — augmentation, reduction, lift or combination — is determined at consultation based on your individual anatomy and goals.
YOUR RECOVERY ROAD MAP
Week 1
The plaster splint stays in place. Your first follow-up is one week after surgery to assess wound healing and deal with any early concerns.
Weeks 2–3
Return to light or desk-based work is typically possible at two to three weeks — depending on the extent of surgery, whether a skin graft was required, and the nature of your occupation.
Weeks 4–8
A structured six to eight week hand therapy programme rebuilds range of motion and strength while reducing the risk of re-contracture as the tissue continues to heal.
Months 3–6
Night-time splinting is maintained for three to six months post-surgery to lock in and preserve the correction achieved. Full functional recovery progresses steadily throughout this period.
WHAT SURGERY ACHIEVES
Outcomes vary with disease severity, but a measurable improvement in hand function is the expected result in the vast majority of cases.
THE CASE FOR SURGERY
Unlike injectable treatments, surgery directly removes the diseased tissue rather than disrupting it — providing more durable correction and a lower risk of early recurrence.
The abnormal cords are frequently wrapped around the digital nerves. Identifying and protecting these structures throughout the procedure requires specialist training and meticulous technique.
No two presentations of Dupuytren’s are alike. The surgical approach — fasciectomy alone, or with skin grafting — is selected based on your specific pattern and stage of disease.
Post-operative hand therapy is part of your treatment from the outset, not an afterthought — maximising the functional benefit of surgery and helping to maintain the result over the long term.
WHERE THE SKILL REALLY MATTERS
What makes Dupuytren’s surgery technically demanding is not the incision — it is the anatomy beneath it. The digital nerves that run alongside the tendons are frequently entangled within the diseased fascia, making their identification and preservation at every step of the dissection non-negotiable.
Professor Hindocha’s approach involves careful loupe-magnified dissection to trace and protect the neurovascular bundles throughout the procedure. This nerve-safe technique reduces the risk of post-operative numbness or, in rare cases, more significant sensory loss.
“
My ring and little fingers had been curled for years. I avoided handshakes and struggled with my keys. After surgery I could open my hand flat for the first time in a decade.
“
The physio programme made a real difference. Within eight weeks I was back at the piano. I only wish I hadn’t waited so long before getting it treated.
“
Professor Hindocha explained everything clearly before and after. I was back at a desk inside two weeks and the long-term result has been excellent.
IS IT TIME TO ACT?
Surgery is not always the first step, but it becomes the right choice once the disease is limiting daily life and conservative measures are no longer sufficient. Common indicators include:
BUILDING YOUR HAND BACK UP
Physiotherapy is not optional after Dupuytren’s surgery — it is a core part of achieving the best possible result. A six to eight week programme of specialist hand therapy begins once the acute healing phase is complete, typically around week four post-surgery.
Your programme is led by a specialist hand physiotherapist working closely with Professor Hindocha. Sessions are tailored to the extent of your surgery, your occupation, and the activities you want to return to — whether that is a keyboard, a garden or a golf club.
Night splinting — which continues for three to six months — is monitored and adjusted by your physiotherapist throughout this period to protect and consolidate the surgical correction as the hand heals and remodels.
WHAT YOUR PROGRAMME INCLUDES
ALSO TREATED BY PROF. HINDOCHA
Related procedures and conditions managed at the same clinic.
HAND SURGERY
Inflammation of the tendon sheath causes the finger to click, catch or lock when bent.
HAND SURGERY
Surgical correction of the basal thumb joint to relieve arthritis and restore pinch grip.
HAND SURGERY
Compression of the ulnar nerve at the elbow, causing numbness and tingling in the ring and little fingers.
READY TO RECLAIM YOUR HAND?
Let's talk about what surgery can do for you.
If Dupuytren’s Disease is bending your fingers out of reach, limiting your grip, or simply getting in the way of daily life, a consultation with Professor Hindocha will clarify your options and the right timing for treatment. Bringing a note of your symptoms and how long you have had them is helpful, but not essential.
QUESTIONS WE HEAR EVERY WEEK
Honest answers to the questions patients ask most often.
Most patients return to light work within two to three weeks. A structured physiotherapy programme runs for six to eight weeks post-surgery. Night-time splinting continues for three to six months to consolidate the correction. Return to heavier physical work and sport typically takes three to four months.
Skin grafting is needed in some cases — typically where the overlying skin has become too contracted to close the wound directly after tissue removal. This adds some complexity to recovery but does not negatively affect the functional outcome when managed appropriately.
Recurrence is possible — Dupuytren’s Disease is a lifelong genetic condition and the underlying tendency remains after surgery. Formal fasciectomy has a lower recurrence rate than non-surgical alternatives. Post-operative splinting and physiotherapy help slow further progression and preserve the surgical result as long as possible.
