Bent fingers that won’t straighten - Dupuytren’s Contracture

Have you noticed one or more of your fingers slowly curling inwards, making it difficult to open your hand fully or lay it flat on a table? If straightening your finger feels impossible rather than simply uncomfortable, you may be experiencing Dupuytren’s contracture — a condition that is far more common than most people realise, and one that is very treatable.

What is it?

Dupuytren’s contracture is a condition that affects the fascia — the layer of tough connective tissue that lies just beneath the skin of your palm. Over time, this tissue thickens and tightens, forming firm cords that gradually pull one or more fingers into a bent position. The ring and little fingers are most commonly affected, though any finger can be involved. In the early stages, you may notice small, tender nodules (lumps) in your palm; as the condition progresses, a cord becomes visible and the finger begins to contract. The bending can eventually become severe enough to interfere with everyday tasks such as shaking hands, wearing gloves, washing your face, or putting your hand in your pocket.

Why does it happen?

The exact cause of Dupuytren’s contracture is not fully understood, but genetics play a major role — it runs strongly in families and is particularly prevalent in people of Northern European descent, which is why it is sometimes called “Viking disease.” Men are affected roughly six times more often than women, and the risk increases with age, typically becoming apparent after the age of 50. Certain factors appear to increase the likelihood of developing the condition, including diabetes, epilepsy, heavy alcohol consumption, and smoking, though none of these is a direct cause. Manual labour and repeated hand vibration have historically been suggested as risk factors, but the evidence for this is less clear.

When should I see a hand surgeon?

You should seek an assessment if you notice a lump or thickened area in your palm that is changing, or if a finger has begun to bend and you can no longer lay your hand flat on a table (a simple self-test known as the “tabletop test”). Earlier assessment is worthwhile because treatment is generally more straightforward when the contracture is less advanced. If the bending is interfering with daily life — for example, making it difficult to type, drive, or carry out your work — it is certainly time to discuss your options with a specialist. Dupuytren’s contracture does not typically cause significant pain, so discomfort alone is not the main guide; it is the functional limitation that matters most.

How is it treated?

There is currently no cream, tablet, or simple exercise that reverses Dupuytren’s contracture once cords have formed. However, there are several effective treatments available. Needle fasciotomy (also called needle aponeurotomy) is a minimally invasive clinic procedure in which a fine needle is used to divide the cord, often achieving a rapid improvement in finger straightening with a short recovery time. Collagenase injection involves injecting an enzyme that breaks down the cord over one or two appointments. For more advanced or recurrent contracture, surgery to remove the affected tissue (fasciectomy) may offer the most durable outcome. Your surgeon will discuss which approach is most appropriate based on the pattern and severity of your contracture, your overall health, and your personal circumstances. All treatments carry a small risk of recurrence, and your surgeon will explain what to expect in the long term.

If you are concerned about bent or curling fingers, Mr Sedwards offers specialist assessment and a full range of treatments for Dupuytren’s contracture. Book a consultation at londonhandandwristsurgeon.com to find out which option is right for you.