Dupuytren’s surgery removes or divides the thickened cords that pull the fingers into the palm. Several techniques are used depending on the severity, including limited fasciectomy (the most common open procedure) and needle fasciotomy.
Open fasciectomy is more involved than other day-case hand procedures. Pre-assessment usually takes place 2-4 weeks before surgery.
You will be seen by a nurse who will perform baseline observations and explain what to expect. Anaesthetic options are discussed in detail at this visit.
Your surgeon will mark the hand and identify exactly which fingers and which areas of the palm need to be treated.
Anticoagulants and antiplatelet medications often need adjustment because the operation can bleed. Specific guidance will be given.
Options include regional nerve block (brachial plexus block) with light sedation, or general anaesthesia. Local anaesthetic alone is sometimes possible for limited surgery.
Hand therapy after surgery is essential. A splint is usually made for night-time use. Confirm arrangements before your surgery date.
Surgery improves but does not always fully straighten severely contracted fingers, particularly at the PIP joint. Recurrence is possible and more likely in people with strong family history or early-onset disease.
You will be given a specific arrival time. Have no food from 2am on the day of surgery; you may drink clear water until 6am, unless your team gives you different instructions. Bring your medication list and any documents from the hospital.
You will be admitted to the day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
You will meet the anaesthetist. Many hand procedures are done under local or regional anaesthetic; some require general anaesthesia.
After surgery you will spend time in the recovery area where nurses monitor your vital signs until you are stable and comfortable.
Arrange for a family member or friend to collect you. You must not drive on the day of surgery if you have had a general anaesthetic or sedation.
Important: Numbness in the operated finger is a recognised risk because the small digital nerves pass through the diseased tissue and have to be carefully separated. Most numbness recovers but can take many months. Tell your team about any sudden change in colour, temperature or sensation.
Avoid getting the wound wet until it is fully healed - usually 10-14 days. Use a waterproof cover when showering. Follow the dressing instructions you are given.
Keep the hand raised above the level of your heart as much as possible for the first 48-72 hours. This significantly reduces swelling, pain, and stiffness.
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, and ibuprofen if appropriate for you) is more effective than waiting.
Unless told otherwise, gently bend and straighten all fingers regularly. Early movement helps prevent stiffness and reduces swelling.
Seek urgent advice if you develop spreading redness, increasing pain, swelling, discharge from the wound, a temperature above 38°C, or any new numbness - these may indicate infection or nerve problems.
Recovery timelines vary between patients and depend on the operation, the demands you place on the hand, and any other health conditions. The timeline below is a general guide - your surgical and hand therapy team will give you personal advice.
Bloods if needed, medication adjustment, splint arrangements, and home preparation.
The operation takes 1-2 hours depending on extent. Most patients go home the same day.
The hand is bandaged and elevated to reduce swelling. Finger movement starts immediately as tolerated.
A night-time splint maintains the corrected position. Daily exercises and scar management with a hand therapist.
Most patients have largely recovered by 3-6 months. Some stiffness can persist longer, particularly with severe pre-operative contractures.
Yes. A custom-made night-time splint is usually worn for several months after surgery to maintain the correction and prevent recurrent contracture.
Most patients can drive again at 3-6 weeks, once the hand is comfortable enough to grip the wheel and perform an emergency stop. Check with your insurer.
Yes - Dupuytren’s is a biological condition, not just a mechanical one. Recurrence affects roughly 20-30% of patients within 5 years. Younger age at onset, family history, and disease in multiple sites all increase recurrence risk.
A less invasive option for cord-type disease, especially at the MCP joint. The cord is divided through small needle punctures under local anaesthetic. Recovery is much quicker but recurrence is more common than after open fasciectomy.
A week-by-week guide to recovery. Individual timelines vary, so always follow the advice of your surgical and hand therapy team.
The aim of surgery is to remove the diseased cords of tissue in the palm so that a bent finger can be straightened, improving the function of the hand. Surgery gives the most complete correction of the available treatments, although the disease can return over time.
The operation is usually done under regional or general anaesthetic, often as a day case. Through a zig-zag incision in the palm and finger, the surgeon carefully removes the thickened Dupuytren cords while protecting the nerves and blood vessels to the finger, which are often closely involved. The finger is then straightened. Occasionally a small skin graft is needed if there is a shortage of skin.
The cord is divided with a needle through the skin. It has a quick recovery but a higher chance of the contracture returning sooner than after open surgery.
An injection that dissolves the cord, followed by manipulation. Availability varies. Recovery is quick but recurrence is more common than after fasciectomy.
Reasonable while the hand still works well. Dupuytren disease is slowly progressive, and a severely bent finger is harder to correct fully and carries higher surgical risk.
The small nerves to the finger run close to the diseased tissue and can be bruised or, rarely, divided, causing numbness. The risk is higher in repeat (revision) surgery.
The small arteries to the finger can be damaged. Very rarely, in severe or revision cases, the circulation to a finger is compromised and, exceptionally, amputation may be needed.
Dupuytren disease tends to come back. Around half of patients have some recurrence within several years, and those with strong (diathesis) disease recur sooner.
Wound edges can be slow to heal, especially in smokers and people with diabetes. A small skin graft may occasionally be used.
A reaction causing prolonged pain, swelling, and stiffness. Most cases settle with intensive hand therapy.
Some numbness is common while bruised nerves recover, and usually improves over weeks to months.
Structured hand therapy and night splinting are an essential part of recovery to keep the finger straight and moving.
The palm and finger are often firm, tender, and swollen for several weeks as healing settles.
Dupuytren disease is slowly progressive and is not painful for most people, so it is reasonable to leave it alone while the hand still functions well, and many people never need surgery. If a finger becomes significantly bent, particularly at the middle (PIP) joint, the contracture is harder to correct fully and the operation carries more risk, so the timing of treatment is worth discussing with your surgeon.