Dupuytren's in plain English

What is Dupuytren's?

It is a condition where the tissue under the skin of the palm slowly thickens. It often starts as a firm lump (a nodule), may form a tight band (a cord), and in some people gradually pulls one or more fingers, most often the ring and little fingers, into a bent position PMID 34225446.

It runs strongly in families and becomes more common with age. It is more common in men PMID 24835475 PMID 24263394 PMID 34225446. It usually progresses slowly, and in a five-year study about 1 in 7 hands stayed the same or improved without treatment PMID 35404338.

What the evidence does say

• There are established ways to straighten a bent finger: surgery to remove the cord (fasciectomy), breaking the cord with a needle (needle fasciotomy), and, where available, an enzyme injection (collagenase).
• They differ mainly in how long the result lasts. In studies with 2–7 years of follow-up, the finger bent again in about 17% of joints after surgery, 33% after collagenase and 46% after needle fasciotomy PMID 41853763. In a large UK trial, collagenase had fewer moderate or severe complications than surgery (1.8% vs 5.1%) but needed repeat treatment more often (14.6% vs 3.4%) PMID 39383454.
• Steroid injections can soften and shrink early nodules, but in one series half of patients' nodules became active again within 1–3 years PMID 11119679.
• Low-dose radiotherapy for early disease has been tested in a randomised trial; whether it prevents progression has not yet been reported PMID 41027544.

What it doesn't say

• No medicine has been shown to stop or reverse Dupuytren's disease. The most promising result so far, injections of the arthritis drug adalimumab, softened early nodules over a year in a trial, but whether that protects the fingers is not yet known PMID 35949922.
• When a medicine has helped, the benefit has tended to fade once it was stopped PMID 24740662.
• Promising laboratory results have often not held up in patients. The other drugs on this site are at the laboratory stage.