Complications of Dupuytren’s Contracture
The complications of Dupuytren’s contracture arise primarily from loss of hand mobility and delayed treatment. Although the condition is not life-threatening, it can have a serious impact on daily functioning, especially if the fingers become fixed in a bent position. Over time, untreated Dupuytren’s contracture can lead to permanent hand deformity, joint stiffness, and reduced quality of life.
The most obvious complication is the progressive inability to straighten the fingers. As the fibrous cords thicken and tighten, the fingers—typically the ring and little fingers—become increasingly curled. This affects grip strength and fine motor tasks like writing, typing, dressing, or using tools. In advanced cases, even shaking hands or placing the hand flat on a surface becomes impossible.
Joint stiffness and contracture can also affect nearby joints, such as the knuckles and wrist. This can create a domino effect, making rehabilitation more difficult and limiting the success of surgical correction. Without proper stretching or therapy, the muscles may weaken and shorten, making movement painful and awkward.
Another major concern is recurrence. Even after successful treatment, Dupuytren’s contracture can return, especially if the underlying genetic or lifestyle risk factors remain unaddressed. Recurrence is more common after surgical removal of cords than after enzyme therapy, but neither approach guarantees a permanent cure.
Complications of Dupuytren’s Contracture
Surgical complications are also possible. These include infection, nerve injury, scarring, delayed wound healing, or reduced sensitivity in the fingers. In rare cases, the skin or soft tissue may not heal properly, particularly if a skin graft is needed. Some patients experience prolonged swelling, stiffness, or hypersensitivity after surgery.
In older adults or those with diabetes, recovery may be slower and more complex. Diabetes, in particular, increases the risk of poor wound healing and infection. Careful post-operative management is essential in these cases to avoid further complications.
Psychological effects are often overlooked but equally important. Losing hand function can lead to frustration, decreased self-esteem, and loss of independence, especially in individuals who rely heavily on manual tasks for work or caregiving. In South Africa, where many people work in agriculture, construction, or domestic roles, limited hand function can mean loss of income or productivity.
Access to specialist care is another challenge. In rural or underserved areas, patients may receive delayed treatment or no rehabilitation, increasing the risk of permanent disability. Community education and awareness are essential to help people recognise early symptoms and seek help before complications worsen.
By understanding the potential complications of Dupuytren’s contracture, patients and clinicians can prioritise early treatment, follow-up care, and long-term monitoring. With the right support, most complications can be managed or avoided altogether.
