Is Dupuytren's surgery needed before hand therapy?

Hand therapy is tailored to the amount of finger bending, stiffness, pain and effect on daily tasks. Before an operation, a therapist may record movement, teach joint protection and suggest ways to keep the hand useful. Therapy cannot remove the thickened cord of Dupuytren's contracture, but it may help maintain practical movement while the condition is monitored.

After surgery, therapy may focus on swelling control, scar care, gradual finger movement, strength and a splint if the surgeon recommends one. The timing depends on the procedure, the incision and the surgeon's instructions. Starting exercises too forcefully can irritate healing tissue, while avoiding movement for too long can increase stiffness.

Ask for an assessment if you cannot place the hand flat, struggle to put on gloves or reach objects, or notice progressive loss of finger extension. Bring details of work, hobbies, diabetes or other conditions that affect healing. A hand therapist and surgeon can compare the likely benefit of therapy alone with an intervention.

If surgery is chosen, agree on the first therapy visit, dressing care, permitted exercises and splint schedule before leaving the surgical team. Follow the written plan and report a sudden change rather than adding extra stretches independently.

Seek prompt advice after treatment for increasing redness, warmth, drainage, fever, worsening pain, a rapidly swollen hand or a finger that becomes pale, blue, numb or difficult to move. Before surgery, arrange review when worsening contracture is affecting hygiene, work or safe use of the hand.

Ask whether therapy alone is suitable now, what movement you should practise, what finding would make surgery more useful, when therapy should begin after surgery, and how the plan changes if swelling, numbness or wound problems occur.