Nonsurgical Treatment: One nonsurgical treatment option for Dupuytren’s contracture is called needle fasciotomy (or needle aponeurotomy). This can be safely done in the medical office or a procedure room. The patient is usually fully awake. The hand and finger are injected with a numbing medicine. In a few minutes when the skin is numb, a needle is inserted below the skin to cut the cord in several locations. The physician then slowly stretches the hand and fingers to break the cord. This allows the hand to be straight again. It is not unusual to develop small tears of the skin that heal over a few weeks. The recovery is only a few days. The hand can be used as much as the patient is comfortable. The wounds must be protected to reduce risk of infection. This procedure does not remove the cord fully from below the skin. Roughly one third of patients will see the cord eventually come back after this procedure.

Another office procedure option is a two-step procedure that includes a collagenase injection. This is similar to needle fasciotomy. Instead, it uses an injectable drug called collagenase to dissolve the cord. The physician will inject the cord at the first visit with the medication. Many patients will experience some swelling, bruising of the hand, and pain after the injection. To limit these symptoms the hand is often wrapped in a bulky dressing. The patient is also instructed to elevate the hand and limit use. Sometimes oral medications are advised such as acetaminophen, a non-steroidal anti-inflammatory drug. The second visit is usually one or a few days later. At that visit, the hand and fingers will be injected again. This time a numbing medication is placed for comfort. A few minutes later, the physician will slowly stretch out and straighten the finger joints to break the cord. Some patients may develop small tears in the skin. Similar to needle fasciotomy, the recovery is only a few days to a few weeks. The hand can be used normally almost immediately once the swelling goes down and the numbing medication wears off. This does not remove the cord fully from below the skin, and one third of patients will see the cord come back. Talk to your doctor about your eligibility to receive this injection.

Splinting and therapy may be used to help keep the hand and fingers straight after the treatment is completed. The main reason to undergo treatment is to increase your ability to straighten the finger. However, it is also very important to work on your ability to make a fist during recovery.