Dupuytren’s contracture release in adults

For the treatment of

Dupuytren’s contracture

Commissioning position

This intervention is commissioned if:

the contracture is worsening AND
significantly impairs function

This intervention is not commissioned for purely cosmetic purposes.

Summary of rationale

The disease process affects the hand to varying degrees and patients may present at different stages in the disease process. It is hence important that the timing and choice of intervention is tailored to the individual patient and based on shared decision making between the patient and a practitioner with clinical expertise in the various treatment options.

It is recommended that as part of the consultation process of patients undergoing intervention, a validated decision aid tool should be used during the consenting process to ensure that the patients’ desired outcomes have been considered. An example of decision aid tool is on the NHS website.

Contractures usually progress and often fail to straighten fully with any treatment if allowed to progress too far. Larger interventions tend to carry a lower risk for recurrence; however, they are associated with complications that can lead to loss of function rather than overall improvement.