Physical Therapy for a Dupuytren’s Contracture

What is Dupuytren’s Contracture?

It is a contracture, shortening, and hardening of tendons in one or more fingers that results in deformity or stiffness causing the fingers to bend towards the palm of the hand. This makes it difficult for the affected fingers to straighten fully. The fingers typically affected by Dupuytren’s contractures are the ring and pinky fingers. While there is no cure for Dupuytren’s contractures, treatment can help relieve symptoms and even slow progression. 

Clinical Signs and Symptoms of Dupuytren’s Contracture: 

• Firm Lump in palm of hand with or without pain
• Hard cord under the skin in the palm which results in the fingers being pulled in towards the palm

Risk Factors for Dupuytren’s Contracture: 

• > 50 years old
• Male 
• Family History 
• Northern European Descent 
• Occupation – increased risk in those who work with vibrating tools. 
• Diabetes 
• Tobacco and alcohol use 

Diagnosis of Dupuytren’s Contracture: 

Dupuytren’s contracture can be diagnosed through palpation of the affected hand. The Physical therapist will be checking for hard knots/bands of tissues and puckering of the skin in the palm. An additional test is placing the hand flat on the tabletop. An inability to place the palm flat indicates need for treatment. The tabletop test can be used to track progression overtime. 

Physical therapy for for Dupuytren’s Contracture: 

Therapy includes manual therapy, stretching, mobility exercises and bracing for the fingers to prevent adhesions from occurring. 

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