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Dupytrens Contracture




Investigations are not usually necessary to diagnose Dupuytren’s disease. However, if the history raises suspicion of diabetes mellitus or alcohol-related liver disease, arrange blood tests as appropriate.


To justify the risks of surgery a flexion deformity must be present.

Surgery for Dupuytrens contractureis commissioned where patients meet the criteria below



Refer for surgery if:

 

  • MCPJ deformity and causing a significant functional impairment* 

OR

  • PIPJ deformity/contracture greater than 20o

OR

  • multiple joints with significant functional impairment *

OR

  • Recurrence after surgery with functional impairment* (consider referral  on first presentation)

AND

  • and the patient is willing to have an operation

 

Dupytrens Contracture Patient Information Leaflet

 

*Note:  Significant Functional Impairment is defined as:

  • Symptoms that result in an inability to sustain employment despite reasonable occupational adjustment, or act as a barrier to employment or undertake education
  • Symptoms preventing the patient carrying out self-care, maintaining independent living or carrying out carer activities

 

For people with Dupuytren’s disease who do not have contracture or any significant loss of function:

  • No treatment is necessary at this stage.
  • Provide an explanation of the condition and reassure the person that any painful nodules should improve with time.
  • Advise the person to return for review if a contracture develops, as referral is then recommended.
  • Corticosteroid injections are not recommended.



References

Dupytren’s Contracture, Clinical Knowledge Summaries, National Institute of Clinical Excellence 2015

http://www.bssh.ac.uk/patients/conditions/25/dupuytrens_disease

KCCG commissioning policy 2019

 

Date reviewed                     8/02/2022

Next review due                  8/02/2023

Sifter name                          Dr Rebecca Hopkins

 

Version No. 1.4