What does treatment address?
Tight cords beneath the skin that pull one or more fingers inward.
These cords develop in the palm’s fascia, a layer of connective tissue. They are not the finger tendons.
Hand & Upper Extremity
Dupuytren’s Contracture Release
Dupuytren’s contracture release loosens or removes tight tissue beneath the palm to help affected fingers straighten and improve hand function.
Is every release an open operation?
No. Options include needle release, an enzyme injection, and open surgery.
The cord’s position, joint stiffness, skin condition, and any previous treatment help determine which approach is suitable.
Can the contracture come back?
Yes. Treatment improves the contracture but does not cure the underlying condition.
A treated finger may bend again, or cords may develop elsewhere in the hand.
01 · Overview
Understanding Dupuytren’s contracture release
Dupuytren’s disease causes tissue beneath the palm to thicken into nodules and cords. Over time, a cord may pull a finger toward the palm, most often affecting the ring or little finger. The condition is often painless, even when it limits hand use. [1]
Release treatment divides a cord or removes affected tissue so the finger can extend more easily. It is different from trigger finger release, which treats catching around a tendon, and carpal tunnel release, which relieves pressure on a nerve at the wrist. [2]
Treatment decisions depend on how much the finger bends, which joints are involved, and how the hand functions. A mild nodule without meaningful loss of movement may only need monitoring. Long-standing joint stiffness can limit how much straightening is possible. [1]
- Treatment area
- Connective tissue beneath the palm and affected fingers
- Main goal
- Improved finger extension and hand function
- Care setting
- Often outpatient; anesthesia depends on the approach
- Long-term outlook
- Recurrence is possible after any treatment
When is treatment usually considered?
Treatment may be considered when contracture interferes with hand use or makes it difficult to place the palm flat on a table. That tabletop observation is useful to discuss, but it does not replace a hand examination.
Does treatment improve the appearance of a palm scar?
The main purpose is to improve finger position and function, not to revise a skin scar. Open surgery creates scars, and changes in skin appearance may remain. Tell your surgeon if existing scars or visible changes are also a concern.
02 · Concerns & Goals
What may bring you to a consultation
A finger that gradually bends toward your palm can make everyday tasks harder. Your surgeon can help you understand whether treatment could improve the activities that matter to you.
A finger that will not straighten
You may find that one or more fingers stay bent even when you try to open your hand.
Everyday tasks becoming awkward
Putting on gloves, reaching into a pocket, washing your face, or placing your hand flat may become difficult.
Cords, nodules, and skin changes
Firm bands, lumps, or puckering in the palm can be noticeable. Treatment for contracture does not necessarily remove every visible change.
A contracture that has returned
Previous treatment can affect the skin, nerves, and available options. Repeat procedures may be more complex.
03 · Options
How the approaches differ
These approaches address the tight cord in different ways. A hand surgeon can explain which are reasonable for your anatomy and goals.
Needle fasciotomy
A needle divides the cord through small skin punctures.
How it worksUnder local anesthesia, the surgeon uses a needle to weaken and release selected parts of the cord.
May suitSome accessible cords, particularly when a less invasive approach is appropriate.
Main tradeoffRecovery is often shorter than after open surgery, but recurrence can occur sooner. Not every cord can be treated safely this way.
Collagenase injection and manipulation
An enzyme weakens the cord before a planned straightening maneuver.
How it worksA clinician injects collagenase into an appropriate cord, then performs finger manipulation at a separate visit.
May suitSelected adults with a palpable cord, when the medication and an experienced clinician are available.
Main tradeoffSwelling, bruising, and skin tears can occur. Tendon injury is a serious risk, and the contracture can recur.
Limited fasciectomy
Open surgery removes selected areas of diseased fascia.
How it worksThe surgeon makes incisions in the palm or finger and carefully separates affected tissue from nearby nerves and blood vessels.
May suitContractures needing more extensive correction or cords unsuitable for less invasive treatment.
Main tradeoffWound care and rehabilitation are generally more involved, and scars, stiffness, nerve injury, and recurrence remain possible.
Dermofasciectomy
Surgery removes affected fascia along with overlying skin.
How it worksA skin graft covers the area where skin and diseased tissue have been removed.
May suitSelected recurrent or extensive disease, especially when the skin is closely involved.
Main tradeoffThe graft and its donor site need care, and healing may take longer. This approach still cannot guarantee that disease will not return.
A release divides a cord; a fasciectomy removes affected tissue. Ask which procedure is being proposed rather than relying on the word “release” alone. [1] [2].
Is the least invasive option always best?
Not necessarily. A shorter initial recovery may come with a greater chance of needing another procedure sooner. Cord location, joint stiffness, skin quality, and your priorities all matter.
Will a stiff joint straighten once the cord is released?
Not always. Joint tissues can become tight after a finger has been bent for a long time. Your surgeon should discuss the correction that appears realistic, particularly for the middle joint of a finger.
04 · Results
What may improve and what may remain
Finger position
Treatment may allow the finger to open farther.
- Complete straightening is not always possible.
- Long-standing contracture and joint stiffness can limit correction.
Daily hand use
The goal is easier use of the hand for meaningful activities.
- Improved extension may help with gloves, pockets, hygiene, and placing the hand flat.
- Swelling, tenderness, and stiffness can temporarily make hand use harder during recovery.
Lasting change
Improvement can last, but further treatment may eventually be needed.
- Recurrence is possible with every approach.
- New disease can develop in other fingers or areas of the palm.
Your starting finger position, involved joints, previous procedures, and treatment choice all affect the likely result. [1]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery differs substantially between needle treatment, injections, and open surgery. Your surgical team should give you a plan for wound care, movement, therapy, and work; returning to work does not mean the hand has fully healed.
Step 1 · Day of the procedure
Treatment day
Depending on the approach, you may leave with a dressing or splint. Confirm how to protect the hand while numb, which movements are allowed, and whether you need someone to take you home.
Step 2 · First days to weeks
Early review and wound care
The team checks wounds, swelling, circulation, and sensation. Injection treatment includes a planned manipulation visit. Open surgery or skin tears may require more wound care.
Step 3 · Following weeks
Movement and hand therapy
Your plan may include guided exercises and a custom splint. The timing and amount of movement depend on the treatment, skin healing, and any graft.
Step 4 · Weeks to months
Building comfortable function
Strength, comfort, and scar softness may improve gradually. More extensive surgery can require a longer recovery, and later follow-up may assess recurrent bending.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Desk work and typingPlanning context: May resume earlier than physical work, depending on the procedure.What affects it: Dressings, swelling, pain, and how much you need the treated hand can limit your pace.
DrivingPlanning context: Wait until you can safely control the vehicle and your team agrees.What affects it: Splints, reduced grip, numbness, and sedating medicines can make driving unsafe.
Lifting and manual workPlanning context: Often require a longer restriction than light tasks.What affects it: Strong gripping or pressure across a healing palm can stress wounds or a skin graft.
Exercise and sportsPlanning context: Return depends on wound healing and the demands placed on your hand.What affects it: Weights, rackets, handlebars, and contact activities need specific clearance.
Ask for restrictions that match your job, hobbies, and treated hand. Follow your surgical team’s instructions rather than a general recovery timetable.
Before your procedure
- Describe which daily tasks are difficult and which improvements matter most to you.
- Share details of earlier hand procedures, injections, injuries, and problems with healing.
- Review all medicines and supplements; do not stop prescribed medicines without guidance.
- Discuss nicotine use, diabetes, circulation problems, and other conditions that may affect healing.
- Arrange transportation and help with tasks if anesthesia, dressings, or limited grip will make them difficult.
- Confirm follow-up visits, access to hand therapy, and any expected time away from work.
Will I need a splint?
Possibly. Some patients benefit from a custom extension splint, but the need and wearing schedule vary. Use it only as directed, and report pressure spots, increased numbness, or color changes.
How should I manage swelling and scars?
Your team will explain hand positioning, permitted movement, and when scar care can begin. Ask your surgical team whether compresses are appropriate and exactly how to use them. Do not begin massage over an open wound or healing graft without clearance.
06 · Safety
Risks and what your clinician assesses
Some swelling, bruising, tenderness, and temporary stiffness are common. Open surgery leaves scars, while needle or injection treatment can cause skin tears. Symptoms should follow the recovery pattern your team describes, not steadily worsen.
Bleeding or infection
Bleeding, a collection of blood, or infection may need additional treatment.
Skin or wound problems
Skin tears, delayed healing, wound separation, or partial skin-graft loss can prolong recovery.
Nerve or blood vessel injury
Injury can cause numbness, altered feeling, or reduced blood flow. Lasting damage is possible, especially in complex repeat surgery.
Tendon injury
Tendons can be injured during treatment, including needle release or collagenase treatment. Repair may require surgery.
Persistent pain or stiffness
Scar sensitivity, reduced movement, or ongoing pain may occur. Rarely, complex regional pain syndrome causes prolonged pain, swelling, and sensitivity.
Incomplete correction or recurrence
The finger may remain partly bent or bend again later. Further treatment may be considered, but repeat procedures can be more difficult.
Discuss these risks and your individual health history with your surgeon. [2]
What your clinician assesses
- The degree of contracture at each joint and whether the joint can be passively straightened
- Cord location, skin quality, sensation, circulation, and tendon function
- Previous treatment, scars, recurrence, and involvement of other fingers
- General health, medicines, nicotine use, and ability to participate in follow-up care
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope: which fingers and joints will be treated, the procedure type, anesthesia, and expected follow-up. An injection plan and an open operation may include different services.
Surgeon
Surgical care
The treating clinician’s procedure fee and planned treatment of the affected cords.
Ask your surgeonAsk which fingers are included and whether manipulation, grafting, or additional procedures are billed separately.
Facility
Anesthesia and facility
The planned anesthesia services and office, surgery-center, or hospital charges.
Ask your surgeonConfirm the treatment setting, separate professional bills, and insurance network status.
Supplies
Supplies and follow-up
Potential charges for medication, dressings, splints, hand therapy, and follow-up visits.
Ask your surgeonAsk which items and visits are included and how extended wound care or additional therapy would be charged.
TRC
Patient Services
Any separately described scheduling, administrative, or care-coordination services.
Ask TRCAsk whether these services carry a fee, what they include, and whether they are optional.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Is Dupuytren’s contracture caused by a tight tendon?
No. The pulling comes from thickened fascia beneath the skin. Tendons are nearby structures that move the fingers and must be protected during treatment.
Should a painless lump be removed right away?
Not usually just because it is present. A surgeon can confirm the diagnosis and assess whether monitoring is appropriate. Treatment decisions focus on contracture, symptoms, and hand function.
Can both hands be treated at once?
Sometimes, but limiting both hands can make dressing, eating, hygiene, and wound care difficult. Your surgeon may recommend staged treatment based on the procedures and help available at home.
Will insurance cover treatment?
Coverage depends on your plan, documented functional limitations, the proposed treatment, and authorization requirements. Ask about medication coverage, therapy limits, network status, and your expected share before scheduling.
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Bring these to help your consultation:
- Confirm the procedure, treated fingers, and realistic functional goals.
- Arrange the individualized recovery plan, follow-up, therapy, and help at home.
- Review the written estimate, insurance requirements, and urgent-contact instructions.
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Sources
- [1]Mayo Clinic — Dupuytren contracture: Diagnosis and treatmentAssessment, monitoring, needle treatment, collagenase treatment, removal of diseased tissue and skin, recovery differences, and recurrence.
- [2]American Society of Plastic Surgeons — Hand SurgeryDistinctions among hand conditions, Dupuytren’s surgical treatment, assessment, wound care and rehabilitation, and hand-surgery risks involving infection, healing, nerves, vessels, tendons, pain, and further surgery.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.