Dupuytren’s Contracture in Austin, TX — Symptoms, Treatment & Surgery | ATX Orthopedics

If you are looking for Dupuytren’s contracture treatment in Austin, TX, the team at ATX Orthopedics can help restore your hand function with the latest minimally invasive options.

If you have noticed a thickening of the skin on your palm, or if one or more fingers are gradually being pulled into a bent position that you cannot straighten, you may have Dupuytren’s contracture. At ATX Orthopedics in Austin, Texas, Dr. Benjamin Amis, MD, a fellowship-trained hand and shoulder surgeon, evaluates and treats Dupuytren’s contracture, including both non-surgical and surgical options.

What Is Dupuytren’s Contracture?

Dupuytren’s contracture is a progressive condition in which the connective tissue beneath the skin of the palm (the palmar fascia) thickens and tightens over time, forming rope-like cords that pull the fingers toward the palm. The ring finger and little finger are most commonly affected, though any finger can develop a contracture. In advanced cases, the affected finger(s) may be permanently bent at 30, 60, or even 90 degrees, making everyday tasks like gripping, shaking hands, or putting on a glove difficult or impossible.

The condition is not painful in most cases, but the progressive loss of finger extension can be significantly disabling.

What Causes Dupuytren’s Contracture?

The exact cause is not fully understood, but Dupuytren’s contracture has a strong genetic component and is more common in people of Northern European descent. Risk factors include:

• Family history — the strongest risk factor; it is sometimes called “Viking’s disease” due to its prevalence in Scandinavian populations
• Male sex — men are affected more often than women and tend to have a more severe course
• Age — onset is most common after age 50
• Diabetes — associated with higher rates of Dupuytren’s contracture
• Alcohol use
• Smoking
• Epilepsy and certain medications

Dupuytren’s contracture is not caused by manual labor or repetitive hand use, despite common misconceptions.

How Is It Diagnosed?

Diagnosis is clinical — Dr. Amis will examine your hand, assess the degree of finger extension loss, and feel for the characteristic cords and nodules in your palm. X-rays are not typically required. The key measurement is the table-top test: if you cannot lay your hand completely flat on a table, you likely have a significant contracture worth treating.

A contracture of 30 degrees or more at the metacarpophalangeal (MCP) joint, or any contracture at the proximal interphalangeal (PIP) joint, is generally considered an indication for treatment.

Treatment Options

Needle Aponeurotomy (Percutaneous Needle Fasciotomy)

For patients with cords but without severe contracture, needle aponeurotomy is a minimally invasive in-office or outpatient procedure in which a fine needle is used to repeatedly puncture and break up the fibrous cord. The procedure takes 20–30 minutes, requires only local anesthesia, and patients can use their hand the same day. Recurrence rates are higher than with surgery, but the procedure can be repeated.

Surgical Fasciectomy

For more advanced contractures, surgical fasciectomy is the most definitive treatment. The operation involves removing the diseased cord tissue from the palm and finger through a carefully planned incision. This procedure offers the best long-term results and is most appropriate when contracture is severe or when needle aponeurotomy is not suitable.

Surgery is performed as an outpatient procedure, usually under local anesthesia using the WALANT (wide-awake local anesthesia no tourniquet) technique. Recovery involves hand therapy and splinting, with progressive return to activity over 4–8 weeks. The involved hand should be protected from heavy use for 6–12 weeks after surgery.

What About Collagenase (Xiaflex) Injections?

Collagenase clostridium histolyticum (marketed as Xiaflex) is an enzyme injection approved for Dupuytren’s contracture that can dissolve the cord without surgery. Dr. Amis can discuss whether you are a candidate for this option at your consultation. Not all cord types respond equally well, and insurance coverage varies.

Why Treat Dupuytren’s Contracture?

Dupuytren’s contracture tends to progress slowly but does not resolve on its own. Waiting too long to treat severe contractures — particularly at the PIP joint — can make recovery more difficult and full straightening less reliable, as the joint and surrounding structures may become permanently stiffened. If you have noticed changes in your palm or difficulty straightening your fingers, early consultation is worthwhile.

Why Choose Dr. Amis at ATX Orthopedics?

Dr. Amis completed his hand surgery training at the CV Starr Hand Surgery Service at St. Luke–Roosevelt Hospital Center in New York City, one of the most respected hand surgery fellowship programs in the country. At ATX Orthopedics, you will see Dr. Amis directly at every appointment — not a midlevel provider. Our practice is built around accessible, surgeon-led care. Most hand procedures are performed at Pinnacle Surgery Center of Austin, our dedicated ambulatory surgery center.

Schedule a Consultation in Austin, TX

If you have a thickened cord in your palm or a finger that won’t straighten, schedule a consultation with Dr. Amis. Treatment options range from a quick in-office procedure to a definitive surgical correction, and the right choice depends on the degree of your contracture and your individual hand function goals. Book online or call (512) 960-4590.

Dupuytren’s Contracture Treatment in Austin, TX

Dr. Gallagher and Dr. Amis offer Dupuytren’s treatment at ATX Orthopedics at Pinnacle Surgery Center of Austin.

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