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Dupuytren contracture

Last reviewed: 3 Apr 2025
Last updated: 14 Jul 2023

Summary

Definition

History and exam

Key diagnostic factors

  • male >40 years of age
  • difficulties with manual activities
  • palmar nodule
  • palmar skin changes
  • pretendinous cords
  • MCP joint contracture
  • proximal interphalangeal (PIP) joint contracture
  • positive Hueston table-top test
Full details

Other diagnostic factors

  • bilateral involvement
  • Garrod nodes
  • involvement of plantar surface of the feet
  • involvement of penis
Full details

Risk factors

  • male sex
  • age >40 years
  • family history
  • diabetes mellitus
  • high alcohol intake
  • smoking
  • trauma
  • anticonvulsant medication
Full details

Diagnostic tests

Tests to consider

  • ultrasound of hand
Full details

Treatment algorithm

ONGOING

no MCP joint or PIP joint contracture

≤30 degrees MCP joint contracture with no PIP joint contracture

>30 degrees MCP joint contracture and/or PIP joint contracture

Contributors

Authors

Craig M. Rodner, MD

Assistant Professor

Department of Orthopaedic Surgery

University of Connecticut Health Center/New England Musculoskeletal Institute

Farmington

CT

Disclosures

CMR declares that he has no competing interests.

Acknowledgements

Dr Craig M. Rodner would like to gratefully acknowledge Dr Thomas H. Trojian and Dr Daniel M. Avery, both previous contributors to this topic. THT and DMA declare that they have no competing interests.

Peer reviewers

Carlos Wigderowitz, MD, PhD, FRCSEd

Senior Clinical Lecturer in Orthopaedic and Trauma Surgery

Department of Orthopaedics and Trauma Surgery

TORT Centre

Ninewells Hospital

Dundee

UK

Disclosures

CW declares that he has no competing interests.

Bill Townley, MD

Specialist Registrar

Plastic Surgery

Salisbury District Hospital

Salisbury

UK

Disclosures

BT is an author of a reference cited in this topic.

Zhongyu Li, MD

Assistant Professor

Orthopaedics

Wake Forest University Baptist Medical Center

Winston-Salem

NC

Disclosures

ZL declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Karbowiak M, Holme T, Khan K, et al. Dupuytren's disease. BMJ. 2021 Jun 4;373:n1308. Abstract

Boe C, Blazar P, Iannuzzi N. Dupuytren contractures: an update of recent literature. J Hand Surg Am. 2021 Oct;46(10):896-906.Full text  Abstract

Ketchum LD, Donahue TK. The injection of nodules of Dupuytren's disease with triamcinolone acetonide. J Hand Surg Am. 2000 Nov;25(6):1157-62. Abstract

Badalamente MA, Hurst LC. Efficacy and safety of injectable mixed collagenase subtypes in the treatment of Dupuytren's contracture. J Hand Surg Am. 2007 Jul-Aug;32(6):767-74. Abstract

Hurst LC, Badalamente MA, Hentz VR, et al. Injectable collagenase clostridium histolyticum for Dupuytren's contracture. N Engl J Med. 2009 Sep 3;361(10):968-79.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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