Can Dupuytren's be cured?

No. The tendency stays for life, but a bent finger can be straightened, and treatment can be repeated if the bend returns.

Is Dupuytren's contracture painful?

Usually not. Early lumps can be tender, but most people seek help because the finger will not straighten.

Should I have needle fasciotomy or surgery?

Needle fasciotomy gives a fast recovery, but the bend tends to return sooner. Surgery takes longer to recover from but lasts longer. The best choice depends on which joints are bent and on your priorities.

Is collagenase injection still available?

Not currently in the UK. Its maker withdrew it from the European market in 2020.

Will it come back after treatment?

It can. It comes back sooner after needle fasciotomy than after surgery, and a repeat treatment is possible.

Dupuytren's Contracture: Treatment and Surgery in London

Dupuytren's Disease to hand with bent/flexed fingers

Dupuytren's contracture is a thickening of the tissue under the skin of the palm. It forms lumps and cords that slowly pull one or more fingers, most often the ring and little fingers, into a bent position. It is usually painless and runs in families. Treatment is worth considering once you can no longer lay your hand flat on a table. The main options are needle fasciotomy, a quick clinic procedure through a needle, and fasciectomy, an operation to remove the cord, which lasts longer before the contracture returns.

Written and reviewed by Mr Dafydd (Taff) Edwards FRCS(Tr&Ortho), Consultant Hand, Wrist and Elbow Surgeon, Cleveland Clinic London. Last reviewed: 31 October 2026.

Private consultations at Cleveland Clinic London, 55 Moorgate, EC2R 6BH. Call 020 3423 7183 or book online.

What is Dupuytren's contracture?

Dupuytren's disease affects the fascia, the layer of tough tissue just beneath the skin of the palm. Over time this tissue thickens, first as small lumps (nodules) and then as firm cords. A cord can pull a finger down into the palm so that it no longer straightens. That bending is the contracture.

It is also called Dupuytren's disease or, informally, Viking disease.

What are the symptoms?

A firm lump or pit in the palm, often near the base of the ring or little finger
A cord running from the palm into a finger
A finger that slowly bends and will not straighten
Difficulty laying the hand flat, shaking hands, wearing gloves or putting a hand in a pocket

It is usually painless. Some early nodules feel tender, but that tends to settle. It is the loss of straightening that matters, not pain.

Who gets it?

It runs strongly in families and is common in people of Northern European descent
Men are affected more often than women, and it usually appears after 50
Diabetes, epilepsy, heavy alcohol use and smoking are linked to it
It can affect both hands, and sometimes the soles of the feet

When should I have treatment?

A lump on its own does not need treatment. Try the tabletop test: place your hand palm down on a table. If you cannot lay it flat, or a finger is bending further, it is time for an assessment. Treatment is simpler and more successful when the bend is less advanced, especially at the middle joint of the finger.
A painful nodule that interferes with your day to day life should also be assessed.
There is no cream, tablet or exercise that reverses a contracture once a cord has formed.

What are the treatment options?

Needle fasciotomy (needle aponeurotomy). A fine needle is passed through the skin to weaken and divide the cord, and the finger is then straightened. There is no surgical wound. Your hand is in a bandage for 2 weeks, and hand therapy starts straight away. The drawback is that the bend returns sooner than after surgery: in studies reviewed by NICE, about half of patients had a recurrence within 3 to 5 years. It suits cords in the palm and people who want a quick recovery, and it can be repeated.
Partial (limited) fasciectomy. Through cuts in the palm and finger, the diseased cord is removed. It is the standard operation and gives the most lasting correction for most people, at the cost of a longer recovery with a wound, a splint and hand therapy.
Total fasciectomy. All of the diseased fascia in the palm is removed, not only the cord. It is used for more extensive disease.
Dermofasciectomy. For severe disease, or when Dupuytren's has come back after earlier treatment, the diseased tissue is removed together with the skin over it. The gap is often covered with a skin graft (a split-skin graft), taken from another part of the body.
Anaesthetic. These procedures can be done under local anaesthetic, a regional block that numbs the whole arm, a general anaesthetic, or a combination. We agree which suits you at your consultation.
Collagenase injection. An enzyme injection (Xiapex) that softens the cord, followed by straightening the finger a few days later. In the UK DISC trial of 672 patients, it worked less well than surgery: more patients needed a further procedure within 2 years (10% compared with 2.5% after surgery). The maker withdrew it from the European market in 2020, and it is not currently available in the UK.
Radiotherapy. Low-dose radiotherapy is sometimes offered for early nodules before a contracture forms. NICE advises that it be used only under special arrangements, because the evidence for long-term benefit is uncertain.

Which treatment is right for me?

It depends on which joints are bent, how far, whether the disease has come back after earlier treatment, and how quickly you need to return to work, sport or an instrument. I will talk you through the trade-off: a faster recovery with needle fasciotomy, or a longer-lasting result with surgery.

How long is recovery?

After needle fasciotomy:
- Bandage: 2 weeks
- Hand therapy: starts straight away
After partial or total fasciectomy:
- Cast: 2 weeks
- Then a splint and hand therapy: 4 to 6 weeks
Hand therapy after surgery is central to keeping the finger straight.

What are the risks?

Recurrence. Dupuytren's is a lifelong tendency, so the bend can return after any treatment. It returns sooner after needle fasciotomy than after surgery.
Nerve or tendon injury. The cords lie close to the nerves of the finger. Injury is uncommon, at about 1% or less in expert estimates reported to NICE for needle fasciotomy.
Skin splitting when the finger is straightened, which usually heals with dressings.
After surgery: wound healing problems, stiffness, and rarely complex regional pain syndrome.

Frequently asked questions

Can Dupuytren's be cured? No. The tendency stays for life, but a bent finger can be straightened, and treatment can be repeated if the bend returns.
Is Dupuytren's contracture painful? Usually not. Early lumps can be tender, but most people seek help because the finger will not straighten.
Should I have needle fasciotomy or surgery? Needle fasciotomy gives a fast recovery, but the bend tends to return sooner. Surgery takes longer to recover from but lasts longer. The best choice depends on which joints are bent and on your priorities.
Is collagenase injection still available? Not currently in the UK. Its maker withdrew it from the European market in 2020.
Will it come back after treatment? It can. It comes back sooner after needle fasciotomy than after surgery, and a repeat treatment is possible.
Book a consultation: 020 3423 7183 or contact the clinic.

Sources

Collagenase injection versus limited fasciectomy for Dupuytren's contracture: DISC, Dias et al., Health Technology Assessment 2024;28(78), and N Engl J Med 2024;391:1499-1510: 672 patients, collagenase less effective than surgery, further procedure by 2 years 10% v 2.5%.
Needle fasciotomy for Dupuytren's contracture: overview (IPG43), NICE, 2003: recurrence about 50% at 3 to 5 years; nerve or tendon injury 1% or less (expert estimate).
Radiation therapy for early Dupuytren's disease (HTG427), NICE, 2016: special arrangements only.
Xiapex: withdrawal of marketing authorisation, European Medicines Agency: withdrawn from 1 March 2020 for commercial reasons.