Should I wait for my Dupuytren disease to get worse and have more hand surgery?

In September I had an operation to remove the tendon-like Dupuytren cord from my upper palm and little finger. Developed a good bit of scar tissue as a result can’t bend the finger yet, so lots of exercises. Just yesterday I noticed nodules in my lower palm where the muscles are being used to do the exercises to get rid of the scar tissue. Went to the doctor today and he confirmed a re-occurrence of Dupuytren contracture just six months after my hand surgery. But he says there is nothing to be done until they curl the fingers. Should I be doing something else because I feel I am in early stage with the Dupuytren cord in my palm?

Thank you,

Robbie Trent


Greetings Robbie,

It is not at all uncommon for Dupuytren contracture to recur in less than a year after having hand surgery to remove the palm lumps and cords that are a part of this problem.  Yours seems to have come back in six months, which is not rare; I hear a lot of these fast recurrences.  I hope your hand surgeon told you all about this.  Again, I hear a lot of stories from people who are not told ahead of time about how the Dupuytren contracture will always come back after surgery.  These people go into surgery thinking that the hand surgery will get rid of their problem, only to find that is not the case.

Dupuytren surgery will only give a temporary relief from the problem, and sometimes the temporary relief if extremely   brief, as in your case.   This is very discouraging because the brief relief comes at the high price of months of surgical pain, poor healing, months of painful exercises, all ending with a hand that is not as good as before the surgery and needing more hand surgery anyway.

You need to talk to your hand surgeon about where all of this is headed.  You should understand that usually the result of additional hand surgery is not a better hand, but a hand that has even more normal tissue removed resulting in risk of greater pain, limitation of movement, coldness, numbness and weakness.  Additionally, you must understand that   typically the speed of recurrence of Dupuytren disease after hand surgery increases with each surgery; each operation seems to make the problem come back a bit faster than the one before it.

You might want to read, Dupuytren hand surgery can be dangerous: Facts you should know  and  My hands got worse after Dupuytren’s surgery, what can I do?  

Notice that at no point do I say that you should not have more hand surgery.  I am just cautioning you that not all surgery is successful – like all Alternative Medicine care is not successful.  You should ask a lot of questions and be sure of what you are getting into because all of the hand surgery sites warn about the return of Dupuytren contracture after surgery.  In my opinion it is better and smarter to first use conservative self-help measures that do not carry the risks of surgery, and only use surgery after all possible conservative options have been used and have failed.

The Dupuytren Contracture Institute has been helping people for over 10 years increase their ability to heal and repair the Dupuytren tissue changes.   Some people get dramatic results and some only slow down the rate of progress; every one is happy for the improvement and progress made because it is better than doing nothing but allow the problem to advance on its own.   I suggest that you go to the DCI website and read a bit about how you might be able to help yourself.



Worse after Dupuytren surgery. Will I ever get any better?


I had my Dupuytren operation on the left hand on small finger and one next to it in June 2011.  I wasn’t going to get it done but my doctor said it was a simple operation.  I had the local anesthetic which was great but little did I know about 4 hours after the Dupuytren surgery that your arm starts to violently jump around and hitting you in face and flopping everywhere for about 10 hours until the anesthetic wore off.  Getting the stitches out a couple of days later was horrendous.  I  mean I can take pain, but this was so painful I could hardly stand it. It is now nearly March 2012, 10 m0nths later, and after all my painful exercises and keeping my splint on every night, my poor fingers are worse than before my hand surgery and the scar is extremely painful. 

Will this ever get any better?  Please advise me.



Greetings Liz,

Sorry to hear your sad story.  People would be surprised to know how common your results are after having Dupuytren’s surgery.   I commonly hear people like you saying that before the operation the surgeon makes the procedure sound like it is a small and simple thing, and always that his/her results are “great,” “wonderful,” and “hardly every any problem at all.”  Then after the surgery when the hand is more painful, or there is suddenly weakness or coldness or numbness that does not go away for years, the same surgeon hides behind the complexity of the procedure and denies making bold promises of a hand as good as new.

I wish I had some magic wand to wave over you and help you out, but there is none.   I cannot tell you if your problem will ever get better.  The best you can do now is to try to salvage what you are able.

The good news is that I have worked with many people like you in the past and in a good percent of cases we can help to reduce pain and maybe begin to get your hand operating better.  There are too many variables with tissue that could have been permanently injured during your surgery, for me to tell you that for sure you can be helped.  Everyone is different and not all surgeons are as good as we would like them to be.

I think you should at least try working with your hand problem by putting yourself on a DCI treatment plan for at least 2-3 months to see if your tissue can make some positive changes.  Some people get small relief, a lot get moderate relief and improvement,  and some get great relief.  You will never know until you try.

I also suggest you contact a very experienced physical therapist who is not affiliated or connected to the hospital in which you had your hand surgery.   You should be able to get an honest opinion and some helpful exercises and stretches to help your tissue to recover – if it is possible.  Time and a lot of work will tell.     

If you have any questions please let me know.   TRH



What should father do about rapid Dupuytren recurrence and weakness after hand surgery?

My father had Dupuytren surgery (he would not have gone through with it had we read about your site beforehand) and he has lost a significant amount of strength in his hand and his pinky finger is already starting to bend again only three months after his surgery in November!   Is there anything you can recommend to help him regain strength and slow down progression of it happening again?     Thank you!


Open-hand surgery for palm lumps and cords has a fairly fast rate of Dupuytren recurrence, so I will assume this is the type of surgery he had.  With his three month reappearance of finger flexion he must must be terribly discouraged.   Many people at this point are advised by the same surgeon that another operation should be done to improve the results of the first surgery.

I advise that your father thinks long and hard about the wisdom of multiple surgeries to accomplish the elusive “surgical correction” for DC.   From my experience while collecting reports from people around the world, people who have rapid Dupuytrens recurrence (fingers flexing toward the palm again, return of palm nodules and cords) or otherwise poor results (pain, finger and hand numbness, coldness and weakness) after hand surgery will find that additional surgeries will usually only lead to an even worse outcome, not a better outcome.   If he is at all considering additional hand surgery he should get a second opinion from the best hand surgeon he can find, preferably from someone who is located far outside the area where he lives.  This is a good idea because if you get a second opinion from someone local it will tend to be less honest and objective.

By following a good upper body and hand exercise program, and using a varied Alternative Medicine treatment plan such as you see on the DCI website, it might be possible for your father to support and enhance his ability to reverse some of contracted tissue.  There is no way to know for sure if this will work for him, especially since he has had one hand surgery.  But I do hear from DCI readers who report variable improvement with these conservative methods.  It is my opinion it is worth the time and effort to see if it can slow down the progression and perhaps even reverse some of the tissue changes.  TRH

What can I do for the pain after Dupuytren surgery and cannot work?




How long ago was your surgery?  Is this your 1st surgery, 2nd or 3rd?  Why are you not able to work?  Is it because of pain, limited finger movement, numbness?

What is the current condition of your hand contracture?    Many people have hand surgery only to find that it does very little to improve their problem and often makes matters worse.  Is that what happened to you? 

I will have a better idea how to reply to you once I understand more about what is happening with you.   TRH

What is needle aponeurotomy or palmar fasciotomy and what are the risks?

Alternative Medicine: Safer alternative than needle aponeurotomy  

Before discussing the Dupuytren contracture surgery known as needle aponeurotomy (NA) and its inherent risks, it is important for the reader to know there is a conservative alternative therapy that avoids the possible side effects and adverse reactions of needle aponeurotomy, also called palmar fasciotomy.  Any Dupuytren’s surgery, even when done well, can have bad unintended consequences as well as stimulate the recurrence of additional nodule and cord formation within a year or two.

Needle aponeurotomy, and other kinds of Dupuytren surgery, is not the only treatment option available.   Alternative Medicine is a conservative and essentially risk free alternative that could make surgery unnecessary.   Most people agree that it makes more sense to use conservative options first, followed by more aggressive and risky options if they are still needed.  However, in the case of Dupuytren contracture most patients are unaware they have other options outside of surgery.

Since 2002 this website has suggested that anyone with Dupuytren contracture should first consider the conservative non-surgical and non-drug treatment options before attempting irreversible surgery.  To learn about Alternative Medicine self-management, please see Different Way of Looking at Dupuytren Contracture Treatment

While all medical websites approach the subject of Dupuytren treatment as though hand surgery and Xiaflex injections are the only options to consider, they intentionally avoid the many diverse Alternative Medicine options that are easy to incorporate and can be used with practically no risk at all. Please read Conservative Philosophy for Dupuytren Therapy

Medical doctors discuss Dupuytren surgery risks

For verification of the risks associated with Dupuytren surgery simply read what hand surgeons have to say.  If the reader goes to the website of a surgeon who specializes in needle aponeurotomy you can read about the dangers of open hand surgery like fasciectomy or even Xiaflex injections.   And, if the reader goes to the website of a surgeon who specializes in open hand surgery you can read about the dangers of needle aponeurotomy.

Each surgical procedure obviously has pros and cons about it, and it us up to the informed patient to know the best option to use.  The intention of this article to simply say that all surgery has a certain level of built-in risk that is best avoided if at all possible.

Risks of needle aponeurotomy

The surgeon cannot see the tip of the needle or the actual tissue being sliced and torn during a needle aponeurotomy, since there is no surgical incision made when performing a needle aponeurotomy.  The surgeon inserts the needle that is used to do the cutting and slicing, and must rely on a high level of skill to only contact and destroy the Dupuytren cord – and nothing else.

There are two risks involved. The first risk is that normal and healthy tendon, ligament, blood vessel and nerve tissue can be accidentally cut instead of the intended targets of palmar fascia contracture and Dupuytren cords.

However, the second risk is greatest.  After a palmar fasciotomy or needle aponeurotomy is done, the cutting and tearing of the Dupuytren contracture tissue accelerates the time for recurrence of another episode of Dupuytren’s contracture when compared to conventional open hand surgery.   The reality of this hand problem is that the contracture will come back at some point after any Dupuytren intervention, and recurrence is statistically faster after needle aponeurotomy than after other types of hand surgery.

Difference between needle aponevrotomy and needle aponeurotomy

There is a simple reason for the difference in terminology encountered while learning about Dupuytren treatment.  Many people find it confusing to occasionally see aponeurotomy spelled a little differently, as in the phrase “needle aponevrotomy.”

Needle aponevrotomy is not an accidental misspelling of needle aponeurotomy. It is simply a matter of a French word being used because the earliest and most innovative development of needle aponeurotomy was done in France, hence the occasional use of the French terminology needle aponevrotomy; both words refer to the same procedure.

Needle aponeurotomy is Dupuytren surgery  

In medical terminology an “-otomy” is a surgical procedure in which the body is cut into, but nothing is removed.  Familiar examples are: tracheotomy, laparotomy, phlebotomy.

The reader will occasionally come upon another –otomy, the term palmar fasciotomy to describe needle aponeurotomy.  In a fasciotomy a type of tissue called fascia is cut but not removed.   Fascia is a kind of thin but tough layer of connective tissue that surrounds, covers and lines all major organs, tissues and cavities of the body.  There is fascia – a lot of it – under the skin on the palm of hand.  During a needle aponeurotomy fascia is cut but not removed, qualifying for this surgery to be called a palmar fasciotomy.

Further, in medical terminology an “-ectomy” is a surgical procedure in which the body is cut into, and something is removed.  Familiar examples are:  Tonsillectomy, appendectomy, and vasectomy.

The reader will also occasionally come upon another –ectomy, as in palmar fasciectomy which is an open hand surgery during which an incision is made to allow for removal of part or all contracted fascia of Dupuytren contracture.   During a palmar fasciectomy sometimes so much fascia and skin is removed that sometimes a skin and fascia graft must be done.

Therefore, a needle aponeurotomy is a surgical procedure that is performed by inserting a needle into a site of deep palmar fascia contracture and nothing is removed.  Instead, once under the skin of the palm, the needle tip is moved blindly around in a variety of directions to intentionally slash, weaken and otherwise disrupt the contracted palmar tissue that causes the reduced finger movement and flexion contracture of Dupuytren’s disease.