Firm palm nodule
A small lump may be the first sign.
Palmar fascia · Finger contracture
Dupuytren’s Contracture Treatment in Manchester
A firm palm nodule or cord can gradually pull one or more fingers toward the palm. Assessment focuses on how much extension has been lost, which joints are involved and whether the contracture is interfering with washing, gloves, pockets, work or sport.
Palm noduleFinger cannot straightenCord under skinRing or little finger
Manchester · UKUK-trained hand specialist · Manchester & Abu Dhabi consultations
Patient guideSymptoms → Diagnosis → Treatment → Recovery
Specialist hand & wrist assessment
What is it?
Thickening and shortening of the palmar fascia beneath the skin.
Is it cancer?
No. Dupuytren’s is a benign fibrous condition.
When treat?
When contracture affects function or reaches a degree where intervention is appropriate.
Can it return?
Yes. Recurrence or extension can occur after any treatment.
Understanding the condition
What is Dupuytren’s disease?
Dupuytren’s disease affects the palmar fascia, producing nodules and cords that can bend fingers toward the palm. It most often involves the ring and little fingers but can affect other digits.
The disease is usually painless and progresses at different rates. A nodule alone does not automatically require treatment; the key issue is loss of extension and functional impact.
Clear diagnosis before treatmentSimilar symptoms can arise from the neck, elbow, wrist, tendons or joints. The examination is designed to locate the true source.
What patients may notice
Symptoms worth checking early.
Symptoms vary with the condition, joint and duration. Persistent pain, stiffness, deformity, a growing lump or loss of function deserves specialist assessment.
Cord under the skin
A rope-like band can extend into a finger.
Finger cannot lie flat
The hand may fail a tabletop test.
Difficulty with gloves or pockets
A bent finger catches during daily tasks.
Skin puckering
The palm can become dimpled or tethered.
Progressive contracture
Extension loss may increase slowly over months or years.
Why it happens
Why Dupuytren’s develops
A useful consultation connects the symptom pattern to the joint or tissue involved and the underlying cause—not just the label.
Genetic tendency
Family history and northern European ancestry increase risk.
Age and sex
It becomes more common with age and is often more severe in men.
Associated health factors
Diabetes, smoking and heavy alcohol use are associated with the condition.
Variable biology
The exact cause is not fully understood and progression is unpredictable.
Focused diagnosis
Find the tissue, the joint and the severity.
Diagnosis is usually clinical. The examination records nodules, cords, joint angles, skin quality, sensation and how the contracture affects daily function.
Bring to your appointmentPrevious X-rays, scans, reports, medication details and information about work or activities that trigger symptoms.
History and progression
Changes over time and family history are discussed.
Tabletop and extension testing
Each finger and joint is measured.
Nerve and joint assessment
Other causes of stiffness or numbness are checked.
Imaging only if atypical
Scans are not routinely required for straightforward Dupuytren’s disease.
Treatment choices
Start with the option that fits the diagnosis.
Surgery is not automatic. Treatment is matched to pain, joint or tissue damage, function, medical health and the patient’s goals.
Non-surgical care
Reduce irritation, protect function and review progress.
- ObservationEarly nodules without functional contracture are commonly monitored.
- Maintain general hand movementNormal use and sensible stretching may preserve comfort but do not remove a cord.
- Education about progressionPatients can monitor extension loss with a tabletop test.
- Treat associated stiffnessHand therapy may help joint stiffness around the condition.
- Review when function changesIntervention is timed according to contracture and goals.
Surgical pathway
Straighten the finger while protecting nerves, skin and joint movement.
- Needle fasciotomyA needle divides selected cords through small punctures; recovery is quick but recurrence can be higher.
- Limited fasciectomyDiseased fascia is removed through an incision for more complete correction.
- DermofasciectomyDiseased skin and fascia are removed with a skin graft in selected recurrent or aggressive disease.
- Joint release or salvageSevere longstanding contracture may require additional joint procedures.
Surgery when appropriate
Dupuytren’s contracture procedures
Treatment is individualised. Needle release may suit a defined cord, while open fasciectomy may be preferred for more complex, recurrent or joint-level disease.
- Measure the contracture and identify the responsible cords
- Discuss recurrence, skin, nerve and stiffness risks
- Release or remove the diseased fascia
- Protect the wound and begin safe movement
- Use splinting and hand therapy when indicated
Realistic expectationsNo procedure removes the underlying tendency to Dupuytren’s. Recurrence or new disease can occur, and severe longstanding joints may not regain full straightening.
Specialist pathwayDiagnosis → Procedure → Therapy → Recovery
Recovery pathway
Healing is staged—not rushed.
Timelines are guides only. The diagnosis, procedure, joint or tissue condition, job and medical health all influence recovery.
First days
Elevate the hand, protect the wound and begin advised finger movement.
1–3 weeks
Wound care and hand therapy progress; recovery is usually faster after needle treatment.
3–8 weeks
Grip and daily use increase while scar and stiffness are managed.
Longer term
Night splinting or therapy may continue, and recurrence is monitored.
4.96/555 verified reviewsWhy consult Dr. Arshad
A clear diagnosis. Practical options. A plan built around you.
Dr. Shoaib Arshad is a fellowship-trained consultant orthopaedic hand and wrist surgeon with UK specialist training and more than 17 years in orthopaedic surgery.
Focused hand, wrist and upper-limb assessmentNon-surgical and surgical treatment pathwaysConsultations in Manchester and across the UK, and at Healthpoint Abu Dhabi
Meet Dr. Arshad ↗Questions patients ask
Dupuytren’s Contracture FAQs.
General information only. Your diagnosis and treatment plan should be based on an individual medical assessment.
Should every Dupuytren’s nodule be treated?+
No. A nodule without contracture is usually observed unless symptoms or the diagnosis are unusual.
What is the tabletop test?+
Place the hand flat on a table. Inability to flatten the palm and fingers suggests meaningful contracture.
Which treatment has the lowest recurrence?+
Recurrence varies with disease biology and procedure. More extensive surgery may last longer but involves a bigger recovery.
Can therapy straighten a fixed cord?+
Therapy alone cannot remove a mature Dupuytren’s cord, but it supports movement and recovery around treatment.
Can I see a Dupuytren’s specialist in Manchester?+
Yes. Dr. Arshad offers specialist hand assessment in Manchester, UK and during UK clinical availability.
Medical referencesPatient information sources used for this guide
Manchester · UK & Abu Dhabi consultation availability
Ready for a clear hand assessment?
Book a specialist consultation and bring any previous X-rays, scans, reports or treatment information.