Dupuytren's disease

Dupuytren’s disease is shortening and thickening of the palmar fascia in the palm or overlying the affected digit(s). These flexion contractures generally develop slowly and are permanent and irreversible. More men than women are affected by this condition. Of note, 20% of people with diabetes will go on to develop Dupuytren's disease. Often diabetics will be more severely affected by this disease.

• Family history, severity and longevity of symptoms, limitation to function.

1. Check for nodules/ cord and record where.
2. Table top test or pen under metacarpophalangeal joint (MCPJ) – can the patient get their hand flat?

3. Measure angle of fixed flexion deformity if able.

• Trigger digit
• RA synovitis.

None required.

• Explanation of cause and natural history
• Self-management and advice, patient information leaflet
• BSSH Dupuytren's disease patient information leaflet.

Diagnostically uncertain.
Minimum degree of contracture >30° metacarpophalangeal joint (MCPJ) and /or significant proximal interphalangeal joint (PIPJ) contracture (BSSH guidance) and/or functional impediment and patient would consider surgery.