Physiotherapy for Post-Operative Dupuytren's Contracture

What is Dupuytren's contracture?

Dupuytren's disease causes progressive fibroblastic thickening and contracture of the palmar fascia, pulling the ring and little fingers into fixed flexion. When a contracture prevents placing the palm flat on a table (table-top test positive), surgical fasciectomy or collagenase release is performed. However, post-procedural rehabilitation determines the ultimate functional outcome. Without dedicated hand therapy, wound contraction, joint stiffness, and aggressive scar formation can rapidly re-bend the fingers. Physiotherapy provides custom night extension splints, scar silicone massage, tendon gliding exercises, and graded grip restoration.

How physiotherapy helps

• Custom thermoplastic night extension splinting
• Active composite finger extension exercises
• Tendon gliding drills for deep finger flexors
• Silicone gel sheeting and scar massage drills
• Gradual grip strengthening and functional use

Common signs

• Firm nodules and cords along the palm pulling the fourth or fifth finger into flexion
• Inability to place the hand completely flat on a table (positive table-top test)
• Post-surgical palmar wound tightness, swelling, and reduced extension mobility
• Difficulty washing the face, wearing gloves, or placing hands into pockets
• Tender scar tissue and joint stiffness at the metacarpophalangeal (MCP) and PIP joints

Clinical rehabilitation framework

Evidence-informed clinical progression and starter exercise targets for Dupuytren's contracture.

Frequently asked questions

Related conditions & care

Trigger FingerTrigger finger (stenosing tenosynovitis) occurs when inflammation, thickening, or nodule formation on the flexor tendon restricts its smooth glide through the first annular (A1) pulley at the base of the finger or thumb. In India, repetitive gripping, heavy domestic activities (such as wringing clothes, chopping, and sweeping), manual tool use, and underlying conditions like diabetes commonly precipitate the condition. As the nodule catches within the tightened pulley sheath, the digit snaps, clicks, or locks in a flexed posture. Conservative physiotherapy combines custom MCP joint splinting to prevent pulley irritation, tendon gliding exercises, gentle deep friction massage, and ergonomic utensil adaptations to restore smooth, painless finger excursion.

Carpal Tunnel SyndromeCarpal tunnel syndrome develops when the median nerve becomes compressed as it passes through the carpal tunnel on the palmar side of the wrist. Increased pressure within the tunnel, often linked to repetitive wrist bending, sustained gripping, fluid retention, or inflammatory changes, causes tingling, numbness, and burning pain in the thumb, index, middle, and radial half of the ring finger. For mild to moderate presentations, conservative physiotherapy focuses on relieving nerve compression, reducing flexor tendon friction, and preserving hand function.

Repetitive Strain Injury (RSI)Repetitive strain injury (RSI) refers to cumulative musculoskeletal pain and tissue strain affecting muscles, tendons, and nerves in the neck, shoulder, forearm, or wrist. It frequently arises from sustained posture, repetitive typing, smartphone use, manufacturing assembly, or manual instruments. Physiotherapy identifies the mechanical drivers of strain, relieves localised muscle and tendon tension, and corrects workstation ergonomics, movement patterns, and load pacing so symptoms do not keep recurring.

Colles FractureA Colles fracture is a complete fracture of the distal radius bone in the forearm with dorsal displacement of the wrist, typically sustained by falling onto an outstretched hand (FOOSH). It is particularly common among older adults with underlying osteopenia or osteoporosis in India, frequently occurring from slips on wet bathroom tiles or unpaved streets. Following 4 to 6 weeks in a plaster cast or surgical fixation with a volar locking plate, patients invariably experience severe wrist joint stiffness, restricted forearm turning (pronation and supination), finger puffiness, and diminished grip power. Post-immobilization physiotherapy focuses on gentle passive and active joint mobilisations, edema reduction, tenosynovial gliding, and graded resistance training to safely restore independence in carrying groceries, preparing meals, and personal care.

Clinical guides & articles for Dupuytren's contracture

Evidence-informed articles, recovery timelines, and home care advice from our clinical library.