The procedures for Dupuytren’s Contracture primarily benefit patients who have progressed beyond the early stage of simple lumps and are experiencing functional impairment due to bent fingers.
Dupuytren’s contracture is a progressive condition of the hand that affects the connective tissue beneath the skin of the palm and fingers. Over time, this tissue can thicken and shorten, forming cords that gradually draw one or more fingers into a bent position. The ring and little fingers are most commonly involved, although any finger may be affected. As the condition progresses, activities such as placing the hand flat on a surface, wearing gloves, or performing tasks that require finger extension can become more difficult.
The exact cause of Dupuytren’s contracture is not fully understood. A genetic tendency is well recognised, and the condition is more common in people of Northern European background. It occurs more frequently in men and is often identified later in adulthood, although it can present earlier. Certain medical conditions are associated with a higher prevalence, but Dupuytren’s contracture can also occur in people without identifiable contributing factors.
Dupuytren’s contracture is not caused by manual work, repetitive hand use, or previous injury. The condition develops within the palmar fascia, a layer of tissue that supports the skin of the palm. As this fascia changes over time, finger movement may become restricted, affecting hand function rather than appearance.
Dr Yezdi Mistry, Specialist Plastic and Reconstructive Surgeon in Charlestown, NSW, approaches Dupuytren’s contracture with careful consideration of functional impact, rate of progression, and individual patient circumstances. In many cases, early-stage changes can be monitored without immediate surgical intervention.
Surgical treatment is not appropriate for every person with Dupuytren’s contracture. In earlier stages, nodules or tightening of the palm may be present without significant limitation of movement. Surgery is generally considered when finger position begins to interfere with everyday hand use.
A commonly used clinical guide is whether the hand can be placed flat on a table. When one or more fingers remain bent and cannot be adequately straightened, further treatment options may be discussed. The degree of joint involvement, the number of fingers affected, the pattern of progression, and the impact on work or daily activities all influence decision-making.
Dr Mistry undertakes a detailed assessment during consultation, taking into account physical findings as well as personal factors such as age, general health, hand dominance, occupation, and any previous treatment. Some individuals present with recurrent disease following earlier intervention, which may require a modified surgical approach.
Any decision to proceed with surgery is made collaboratively. Patients are supported to understand the nature of the condition, the aims of treatment, and the importance of post-operative rehabilitation.
Surgical treatment for Dupuytren’s contracture aims to support improved finger extension and hand function. By addressing the tightened cords of fascia, surgery may assist with changes in finger movement that support everyday activities such as gripping objects, placing the hand into confined spaces, or performing fine motor tasks.
It is important to recognise that surgery does not remove the underlying tendency for Dupuytren’s contracture to develop. Further changes within the palmar fascia may occur over time, and recurrence is recognised even after appropriate treatment. Surgery addresses existing finger position rather than preventing future progression.
Dr Yezdi Mistry discusses realistic expectations with each patient prior to surgery. The degree of change achieved depends on the severity of contracture, the joints involved, and whether the condition has been treated previously. In more advanced cases, full finger straightening may not be achievable, although functional improvement is often possible.
Treatment planning is guided by functional considerations and long-term hand use rather than cosmetic outcomes.
Clinical photography may be used as part of the medical record for individuals undergoing treatment for Dupuytren’s contracture. Images document finger position, joint involvement, and hand function before and after treatment. These records support assessment, surgical planning, and follow-up. They are presented to support understanding of the condition and surgical approach rather than to suggest outcomes.
Surgery for Dupuytren’s contracture is performed as a planned procedure, usually under general or regional anaesthesia depending on the extent of disease and individual considerations. Dr Yezdi Mistry applies specialist training in hand and reconstructive surgery to address affected tissue while carefully managing surrounding structures.
The most commonly performed procedure is a fasciectomy. This involves carefully planned incisions in the palm and affected fingers to allow access to the abnormal cords of fascia. Incision placement is selected to support wound healing and post-operative hand movement.
In some cases, a limited fasciectomy may be appropriate, where only selected areas of affected tissue are removed. More extensive or recurrent disease may require a broader surgical approach. The technique used is tailored to the pattern of contracture and joint involvement identified during assessment.
Following removal of the affected tissue, the fingers are gently adjusted towards a straighter position. Skin closure may involve local skin adjustments to accommodate the change in finger position. A dressing and splint are applied to support early healing.
Dr Mistry’s clinical experience as a Specialist Plastic and Reconstructive Surgeon, together with his public hospital work in hand surgery, informs his structured and careful approach.
All surgical procedures involve potential risks, and Dupuytren’s contracture surgery is no exception. Understanding these considerations is an important part of informed decision-making.
Possible complications include wound healing concerns, infection, bleeding, and scarring. Because nerves and blood vessels are closely associated with the affected tissue, changes in sensation or nerve irritation can occur. Joint stiffness may develop, particularly if post-operative hand therapy is limited.
Swelling and discomfort may persist for several weeks. Over the longer term, further changes related to Dupuytren’s contracture can occur, including recurrence of finger contracture.
Dr Yezdi Mistry discusses these possibilities during consultation and adopts surgical techniques that help reduce avoidable complications.
Recovery following Dupuytren’s contracture surgery occurs gradually and requires active participation. Immediately after surgery, the hand is protected with a dressing and splint. Elevation of the hand is commonly recommended in the early period to assist with swelling management.
Hand therapy is a key part of recovery. Patients are usually referred to a qualified hand therapist who provides exercises to support finger movement, joint flexibility, and strength. Splinting may be recommended at certain stages, depending on healing progress.
Sutures are commonly removed within two weeks, although this can vary. Light activities are reintroduced progressively, while more demanding hand use may take longer. Recovery timelines differ based on the extent of surgery, the fingers involved, and individual healing responses.
Dr Mistry provides structured post-operative guidance and works closely with hand therapists to support recovery as anticipated.
Long-term care following Dupuytren’s contracture surgery focuses on maintaining hand movement and monitoring for further changes. Ongoing exercises may be recommended to support joint mobility beyond the initial recovery phase.
Patients are encouraged to remain aware of changes such as new nodules or tightening within the palm or fingers. Early review can assist with timely assessment if changes are noted.
Dr Yezdi Mistry offers continued follow-up for individuals treated at his Charlestown practice, supporting continuity of care over time.
The cost of Dupuytren’s contracture surgery in New South Wales varies between individuals. Factors include the extent of disease, the complexity of surgery, hospital or day surgery facility fees, anaesthesia, and post-operative care such as hand therapy.
During consultation, Dr Mistry’s team provides clear information regarding anticipated fees and what they include. These discussions are conducted transparently and in line with Australian healthcare regulations.
Preparation for Dupuytren’s contracture surgery begins with a comprehensive consultation. This includes review of medical history, detailed hand examination, and discussion of treatment options. Additional assessments may be recommended where appropriate.
Patients may be advised to adjust certain medications prior to surgery and to plan time away from work or usual activities. Organising assistance at home during the early recovery period may also be helpful.
Clear written instructions are provided so patients understand what to expect before and after surgery. This approach reflects Dr Yezdi Mistry’s commitment to patient-centred care and informed decision-making.
Yes. It is common for Dupuytren’s contracture to be present in both hands, although the pattern and severity may differ between sides. Treatment planning considers each hand separately based on function and progression.
The changes associated with Dupuytren’s contracture begin in the palmar fascia and often involve the palm before affecting finger position. Tightening within the palm can influence how the fingers move over time.
Not necessarily. The decision to consider surgery depends on functional limitation, rate of change, and individual circumstances rather than diagnosis alone. Observation or non-operative management may be appropriate in some situations.
Yes. Surgery addresses the existing changes in the fascia, but the underlying tendency for the condition to develop remains. Further changes may occur over time and can be monitored during follow-up.
Grip strength may feel reduced during early recovery due to swelling and stiffness. With hand therapy and gradual use, many individuals regain functional strength over time, although this varies.
This depends on the pattern of contracture and functional priorities discussed during consultation. In some cases, treatment is focused on the fingers causing the greatest limitation.
Hand therapy plays a central role in recovery by supporting finger movement and joint flexibility. Adherence to therapy recommendations can influence how the hand functions over time.
The condition itself does not usually alter sensation, but the cords are located close to nerves. Changes in sensation can occur as part of the condition or following surgical treatment and are discussed during consultation.
No. Recovery varies depending on the extent of surgery, the fingers involved, and individual healing responses. Dr Yezdi Mistry provides guidance tailored to each person’s circumstances.
Not necessarily. While Dupuytren’s contracture can occur alongside other conditions, it does not automatically indicate additional hand disorders. Each concern is assessed on its own clinical features.
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Please Note: Information provided on Dr Mistry’s website is provided as a basic guide, it does not constitute a diagnosis and should not be taken as medical advice. Any surgical or invasive procedure carries risks.
“I care because it’s my job as a surgeon, as a plastic surgeon, to do the appropriate thing and to give you a good outcome. I want to leave knowing that I can tell a patient, hand on heart, that I did the very best I could and that I looked after them, so when I see them post op later that day or the next morning, that they feel they were in good hands.”
– Dr Yezdi Mistry
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