When Is It Time to Consider Surgery for Dupuytren's Contracture?
Health ConditionsSkin ConditionsDupuytren's Contracture

Dupuytren's Contracture: Is Surgery Right for Me?

Dupuytren's Contracture: Is Surgery Right for Me?
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Published on June 3, 2025
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If you have Dupuytren's contracture, you're likely familiar with the many nonsurgical ways to manage the condition, including hand exercises, physical therapy, and injections. While these treatments are helpful in mild cases, they become less effective as your condition worsens.

If you’re starting to experience significant limitations with your hands, it may be worth considering surgery. Here’s everything you need to know, including how to determine if surgery is right for you and the best surgery options.

Should You Consider Surgery for Dupuytren's Contracture?

For more advanced cases of Dupuytren’s contracture, surgery is the most common treatment.

 While getting surgery is a personal decision, there are some factors that can indicate it’s a good option, including:
  • The Tabletop Test Try laying your hand out flat, palm down, on a table. If your hand can’t lie completely flat, you might be a good candidate for surgery. “This test symbolizes the amount of dysfunction or limitation in the hand,” says Sam Fuller, MD, a hand surgeon at South Bend Orthopaedics in South Bend, Indiana. When it comes to surgery outcomes, your level of contracture matters: If it’s at 30 to 40 degrees, you may have a better outcome (and less risk) than if it’s at 90 degrees. So, it’s best to consider surgery before contraction becomes too severe.
  • Your Quality of Life Consider how much Dupuytren’s contracture is affecting your ability to work, do hobbies, and perform other daily activities. “For instance, those whose professions or hobbies demand a high degree of manual dexterity might find even a mild contracture more significantly impactful,” says Anand Shah, MD, an orthopedic surgeon specializing in hand and wrist surgery at DISC Sports and Spine Center in Valencia, California.
  • Your Prior Medical History and Prognosis Your doctor will consider whether you’ve already had prior surgery for the condition, as well as the overall severity and progression of your particular case. “[These] are important elements to take into account when discussing treatment options,” adds Dr. Shah.

If you have any concerns about the progression of your hand mobility and think surgery might be a good option for you, talk to your doctor about the best course of action.

Types of Surgery for Dupuytren's Contracture

There are three types of surgery used to treat Dupuytren’s contracture. The right surgery for you will depend on several factors, including the severity of your condition, your age, and whether there are single or multiple cords, or rope-like bands of tissue, involved. Taking all of these into consideration, your treatment options may include:

  • Fasciectomy For most cases, the standard surgery for Dupuytren’s contracture is a limited fasciectomy, says. Dr. Fuller. The process involves removing a portion of the diseased cord in your hand. Your doctor may also opt to perform a total fasciectomy to remove all of the diseased cords, nodules, and pitting in your hand. “This will allow the finger to straighten and flex without impairment,” Fuller notes. In one study, over 90 percent of people who underwent some form of fasciectomy had excellent or good results, and recurrence rates are low — up to 20 percent.

  • Fasciotomy For this procedure, your doctor treats the affected fascia (connective tissue) to release tension in the hand. It can be done by surgery, needle, or with a collagen injection. While less invasive than a fasciectomy, a fasciotomy can also be less effective in the long run, with recurrence rates of up to 48 percent in one study. And most recurrences typically happen within the first two to three years post-surgery.

  • Needle Aponeurotomy Another minimally invasive procedure, needle aponeurotomy involves using a needle to break the affected cord, allowing the fingers to straighten. While you will notice results right away, the recurrence rate is somewhere around 50 percent, especially in more severe cases.

“It's important to note that when less tissue is removed, there is generally a higher risk of recurrence,” says Shah. While more invasive procedures may take longer to heal, they also reduce your chance of the contracture recurring and requiring further treatment.

If you think surgery may be the right choice for you, talk to your doctor about your particular case and which option might be best.

The Takeaway

  • Surgery is recommended for advanced Dupuytren’s contracture, especially if you can’t lay your hand flat (tabletop test) or if the condition interferes with daily activities and work.
  • Earlier surgical intervention leads to better outcomes, particularly when contracture is under 40 degrees.
  • Fasciectomy is the most common and effective surgical option, with low recurrence and high success rates.

Common Questions & Answers

What if I decide not to have surgery?
Your doctor will recommend other ways to treat your Dupuytren’s contracture, such as physical therapy. “In these cases, I typically emphasize the importance of close monitoring of the affected fingers, as more severe contractures can become increasingly difficult to treat later on,” says Shah. Your doctor may suggest surgery at a later time.
Risks include bleeding, infection, wound healing issues, injury to nerves resulting in numbness, and limited release of the fingers, Fuller says. Your doctor will weigh the potential risks against the severity of your condition and the benefits of surgery.
Full recovery typically takes one to two months. “Since Dupuytren's surgery involves removal of the fascia but does not require repair of tendon or fixation of bone, the recovery process ranges from four to eight weeks,” says Fuller. “The exact time depends more on the severity of the contracture, length of the incision and dissection, as well as patient-specific factors, such as age and other health issues.”

Follow all of your doctor’s instructions post-surgery, and go to follow-up appointments. “Some people may benefit from physical therapy to aid with scar management and to improve their range of motion, depending on the extent of their contracture before surgery,” says Shah.

You can also wear splints while you sleep. “These can be worn at nighttime for three to four months to reduce the risk of recurrence,” Fuller adds. 

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Dupuytren's Contracture. Johns Hopkins Medicine.
  2. Aykut S et al. Surgical treatment results for dupuytren's disease. Acta Ortopédica Brasileira. May 2017.
  3. Artuso M et al. Dupuytren’s contracture: Is a history of percutaneous needle fasciotomy a risk factor for postoperative complications after secondary open fasciectomy? A retrospective study of 62 hands. Orthopaedics & Traumatology: Surgery & Research. April 2025.
  4. Strömberg J. Percutaneous Needle Fasciotomy for Dupuytren Contracture. JBJS Essential Surgical Techniques. March 2019.
  5. Herrera FA et al. Modified Percutaneous Needle Aponeurotomy for the Treatment of Dupuytren's Contracture: Early Results and Complications. Hand. February 2015.
Additional Sources
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Sanjai Sinha, MD, is a board-certified internal medicine physician and an assistant professor of clinical medicine and the director of the care management program at Weill Cornell Medical College. Helping patients understand health information and make informed decisions, and communicating health topics effectively both in person and through patient educational content, is a challenge that animates his daily life, and something he is always working to improve.

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