In Dupuytren's contracture, when is surgical release indicated?

In Dupuytren's contracture, when is surgical release indicated?

• A. MCPJ contracture of 60° or greater
• B. Surgical release is indicated when the MCPJ contracture reaches 30° or with any degree of contracture of the PIPJ
• C. Intralesional injection is always preferred
• D. There is no surgical option, only observation

Answer: (B)

In Dupuytren’s contracture, the decision for surgical release hinges on functional impairment. The goal is to restore hand use, not just to straighten fingers. An MCP joint contracture of about 30 degrees or more typically impairs grip and daily tasks, so it’s a common threshold for proceeding with surgery. Any contracture at the PIP joint also supports operative treatment because PIP involvement tends to be more disabling and harder to correct nonoperatively. If the contracture is mild and not affecting function, observation or nonoperative management may be reasonable. Intralesional injections can reduce cords in some cases, but they are not universally preferred as the sole treatment, and surgery remains the definitive option when function is compromised.

In Dupuytren’s contracture, the decision for surgical release hinges on functional impairment. The goal is to restore hand use, not just to straighten fingers. An MCP joint contracture of about 30 degrees or more typically impairs grip and daily tasks, so it’s a common threshold for proceeding with surgery. Any contracture at the PIP joint also supports operative treatment because PIP involvement tends to be more disabling and harder to correct nonoperatively. If the contracture is mild and not affecting function, observation or nonoperative management may be reasonable. Intralesional injections can reduce cords in some cases, but they are not universally preferred as the sole treatment, and surgery remains the definitive option when function is compromised.