Dupytren's contracture

DGRefHelp - NHS Dumfries & Galloway
NHS Dumfries and Galloway

Signs /Symptoms

  • Characterised by Chords and Nodules in Palm / Fingers
  • Flexion deformities typically at MCPJs and PIPJs
  • Not usually painful
  • Can slowly progress over months/years or have a rapid progression since onset

Advice in Primary Care

  • No evidence splintage or exercise arrests development of contracture
  • Good practice to avoid gripping over prolonged periods – take regular breaks to stretch the hand and fingers

Actions in Primary Care

  • Direct Patient to NHS Inform Website for further info - https://www.nhs.uk/conditions/dupuytrens-contracture/
  • Perform a Heustons Table Top Test i.e. lay hand palm down flat on table.
  • IF Negative (flat hand - no gaps) – No further action required. Advise patient to monitor Table Top Test regularly.

Referral to Secondary Care

  • Positive Heustons Table Top Test i.e. unable to lay hand flat , gaps between palm/fingers and table (push a pencil through)
  • Obvious flexion deformity at either MCPJ / PIPJ or both

Refer via SCI Gateway to Occupational Therapy Hand Clinic and include following in referral:

  • Description of deformities i.e. flexion of MCPJs or PIPJs
  • ONLY refer if patient wishes to pursue surgery (Do not wait until finger fully flexed to palm)
  • Refer urgently if there is a soft tissue lump or swelling which is rapidly increasing in size, painful or has atypical features.
  • Duration of symptoms

Editorial Information

Last reviewed: 23/01/2024

Next review date: 23/01/2025

Version: 1

Reviewer name(s): Jan Beaumont.