Reserved for recurrent or aggressive cases, this involves removing the diseased tissue and overlying skin, followed by a skin graft. It reduces the chance of recurrence but is more invasive and requires a longer recovery period.
Dupuytren’s
Quick Summary
Restore Hand Function with Expert Care
Dupuytren’s disease, also known as Dupuytren’s contracture, causes the fingers to curl inward due to thickened cords in the palm. Over time, it can interfere with simple daily tasks like shaking hands or placing your hand flat on a table.
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Dr Ali Soueid is a UK Certified & Trained Plastic Surgeon
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What is a Trigger Finger
Dupuytren’s disease (or Dupuytren’s contracture) is a progressive condition that affects the connective tissue under the skin of the palm. Over time, this tissue thickens and forms cords that can pull one or more fingers into a bent position, typically affecting the ring and little fingers.
The condition is not caused by injury and often develops slowly over months or years. While it may start as a small lump or nodule in the palm, it can eventually limit hand movement and interfere with everyday activities like writing, gripping, or putting your hand in your pocket.
Dupuytren’s disease is more common in men over 50, particularly those of Northern European descent, but it can affect anyone. If caught early, minimally invasive options may help delay or prevent the need for surgery. Dr Ali Soueid specialises in the diagnosis and treatment of Dupuytren’s disease, offering expert care in Beirut, Qatar, Dubai, and London.
Comparison: Mild vs Advanced Dupuytren’s Disease
| Feature | Mild Dupuytren’s Disease | Advanced Dupuytren’s Disease |
|---|---|---|
| Symptoms | Small lump or nodule in the palm | Visible cords and finger contractures |
| Finger Movement | Normal or slightly reduced | Significant loss of finger extension |
| Daily Activities | Usually unaffected | Difficulty gripping, writing, or washing hands |
| Pain | Usually painless | Still often painless, but may cause discomfort when active |
| Appearance | Flat or slightly raised area in palm | Fingers bent towards palm, cords visibly tethered |
| Treatment Options | Observation, hand therapy, steroid injections | Surgery (fasciectomy or needle aponeurotomy) |
| Risk of Progression | May remain stable for years | Likely to worsen without intervention |
| Response to Non-Surgical Treatment | Often good | Limited – usually requires surgical release |
Grades of
Dupuytren's
Progressive Finger Contracture
You may be a good candidate for treatment if you're experiencing increasing difficulty straightening one or more fingers. If the contracture is interfering with daily tasks like shaking hands, putting your hand in your pocket, or using a keyboard, it’s time to seek medical advice. Even early-stage contractures that are worsening over time may benefit from early intervention.
Visible Nodules or Cords
Patients with thickened nodules or cords in the palm—even if they don’t yet have significant contracture—can also be candidates. These signs indicate active disease and may progress without treatment. Early treatment, including collagenase injections or needle aponeurotomy, may prevent the need for more invasive surgery later on.
Failed Conservative Management
If splinting, stretching, or other conservative methods have failed, or if the disease has recurred after previous treatment, surgical options may be considered. Patients in good general health with realistic expectations often have excellent outcomes with procedures like limited fasciectomy, especially when performed by an experienced plastic surgeon like Dr Ali Soueid, who treats patients in Beirut, Qatar, Dubai, and London.
Who is a good candidate?
Before undergoing Dupuyten’s Disease Surgery, a thorough consultation is carried out. Here’s what we evaluate:
Finger Examination
Medical History
Expectations
What are the
Benefits of Treating Dupuytren’s Disease
Restored Hand Function
One of the main benefits of treating Dupuytren’s disease is the ability to regain full or improved use of the affected hand. As the disease progresses, it can cause the fingers—especially the ring and little fingers—to curl inwards, making everyday tasks difficult. Treatment helps restore movement, grip strength, and dexterity, allowing patients to return to normal routines without discomfort or limitation.
Prevention of Deformity
Early treatment can prevent the disease from reaching an advanced stage where permanent joint stiffness or tendon damage may occur. Non-surgical interventions such as collagenase injections or needle fasciotomy can stop the progression if caught early. By acting promptly, patients can often avoid more invasive surgery and long-term disability.
Prevents Joint Stiffness
From being able to shake hands comfortably to typing or holding tools with ease, treatment can significantly enhance a patient's quality of life. Reducing pain, improving hand appearance, and boosting confidence are all valuable outcomes. With expert care from plastic surgeon Dr Ali Soueid, patients experience safe, tailored management.
Steps Towards Achieving Your Goals
In Three Easy Steps
1. Consultation
A Consultation helps you give your desires to us and helps us take a thorough history, do an examination and order investigations.
2. Procedure
The day of the procedure is a big day for the patient and we take every measure to make sure your are comfortable and safe.
3. Recovery
We will support in this essential part of your journey to make it as smooth as possible.
Preparation & Aftercare
Follow these instruction to prepare for your procedure and to have a smooth post-operative recovery.
Pre-Op
Before undergoing treatment—whether surgical or non-surgical—Dr Ali Soueid will perform a detailed hand assessment and may request imaging or blood tests, especially if general health concerns exist. You’ll be advised to: Arrange transport, as driving may not be possible after the procedure. Inform the clinic of any medications, especially blood thinners or diabetes treatments. Plan time off work and daily activities depending on the procedure (from 1–2 days for injections to 2–3 weeks for surgery)
What to Avoid
To reduce risk of complications, patients are advised to avoid: Smoking for at least 2 weeks before the procedure, as it delays healing. Taking aspirin or anti-inflammatories unless approved by Dr Soueid. Applying lotions or creams to the hand the night before surgery. Eating or drinking on the day of surgery (if general anaesthetic is planned)
Post-Op
Recovery depends on the procedure, but general aftercare includes: Keeping the hand elevated for 48 hours to minimise swelling. Gentle movement as advised by the physiotherapist to maintain flexibility. Stitches are usually removed 10–14 days after surgery (if applicable). Splinting or hand therapy may be needed for a few weeks in surgical cases. Avoid heavy lifting, gripping, or driving until cleared by your surgeon.
DIFFERENT TREATMENT OPTIONS
Collagenase Injections (Xiapex®)
A non-surgical treatment where an enzyme is injected directly into the thickened cord to weaken it. The finger is then gently manipulated to break the cord and improve extension. It’s ideal for patients with moderate contractures and minimal joint stiffness. Recovery is quick with minimal downtime.
Needle Fasciotomy
A minimally invasive outpatient procedure using a fine needle to divide the cord under local anaesthesia. It provides immediate improvement with little scarring. Best suited for softer cords and selected contractures without severe joint involvement.
Limited Fasciectomy
A surgical procedure where the diseased tissue is removed through a precise incision. It offers longer-term results, especially in advanced cases. Recovery involves hand therapy and splinting, but outcomes are generally excellent.
What to expect
During Your Dupuytren's Disease Treatment
Treatment for Dupuytren’s disease depends on how advanced the contracture is and which fingers are affected. Whether you are being treated in Beirut, Qatar, Dubai, or London, Dr Ali Soueid will tailor the approach to restore your hand function with minimal downtime.
Minimally Invasive Options
If the disease is caught early or involves mild to moderate contracture, a needle fasciotomy or collagenase injection (Xiapex) may be recommended. These are performed under local anaesthesia in a clinic setting. You may feel some pressure or discomfort during the procedure, but it’s usually well tolerated.
With needle fasciotomy, a fine needle is used to release the cord causing the finger to bend. In enzyme injection, the cord is chemically weakened and then manually snapped after 24–48 hours. The results can be immediate, though mild bruising, swelling, or skin splitting may occur. Most patients return to light activities within a few days.
Surgical Treatment
For more advanced cases or recurrences, Dr Soueid may recommend an open fasciectomy — a surgical procedure to remove the thickened tissue. This is usually done under regional or general anaesthesia in a hospital or day surgery unit. The procedure takes about 1 to 1.5 hours depending on the severity.
After surgery, your hand will be dressed and sometimes splinted in a straight position. Discomfort, swelling, and tightness are normal in the first few days. Stitches are typically removed after 10–14 days, and hand therapy is often advised to improve movement and prevent scar stiffness.
Recovery and Long-Term Outlook
Most patients experience a noticeable improvement in finger extension and grip. Light use of the hand is usually possible within 1–2 weeks for minor procedures, and around 3–4 weeks for open surgery. Full recovery and return to heavy activities may take 6–8 weeks.
Dr Soueid and his team will guide you through post-operative care, wound management, and tailored exercises. Regular follow-up is essential to monitor healing and watch for signs of recurrence, which can happen over time in some cases. With proper care, long-lasting results are achievable.
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FAQ
What causes Dupuytren’s disease?
Dupuytren’s disease is a genetic condition that causes thickening of the fascia (connective tissue) in the palm, leading to finger contractures. It tends to run in families and is more common in men over 40 of Northern European descent.
Is Dupuytren’s disease painful?
The condition is usually painless, although some patients may feel tightness or discomfort in the palm as the cords form and contract. Pain is not typically a driving symptom for treatment.
Can Dupuytren’s disease go away on its own?
No, Dupuytren’s disease is progressive and does not resolve without treatment. While it may remain stable for years, once contractures develop, intervention is often required to restore hand function.
What are the first signs of Dupuytren’s contracture?
Early signs include a firm lump or nodule in the palm, followed by the development of a tight cord and gradual inability to straighten the fingers, especially the ring and little fingers.
When should I see a specialist like Dr Ali Soueid?
If you notice finger stiffness, palm nodules, or difficulty placing your hand flat on a table (the “tabletop test”), you should consult a hand surgery expert like Dr Ali Soueid in Beirut, Qatar, Dubai, or London for assessment and early treatment options.
How effective is non-surgical treatment?
Minimally invasive treatments like needle fasciotomy or collagenase injection are effective for mild to moderate cases, with high patient satisfaction and short recovery times. However, recurrence rates may be higher than with surgery.
What does surgery for Dupuytren’s involve?
Surgery, such as limited fasciectomy, involves removing the affected tissue through small incisions. It is performed under anaesthesia, and recovery may take several weeks depending on the extent of disease.
Is physical therapy required after treatment?
Yes, hand therapy is highly recommended after surgery or injection to reduce stiffness, restore function, and minimise scar contracture. Dr Soueid’s team will provide tailored rehabilitation plans.
Can Dupuytren’s disease come back after treatment?
Unfortunately, recurrence is possible, especially in younger patients or those with aggressive disease. Dr Ali Soueid uses evidence-based techniques to reduce recurrence risk and monitors your progress long-term.
Does health insurance cover Dupuytren’s treatment?
In most countries, Dupuytren’s contracture is considered a medical condition, not cosmetic, and is covered by insurance. Dr Soueid’s administrative team can assist with documentation for your specific location and policy. quick recovery or long-term relief, a tailored treatment plan will be offered to suit your needs.
