Dupytren's contracture | Right Decisions

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Signs /Symptoms

Characterised by Chords and Nodules in Palm / Fingers
Flexion deformities typically at MCPJs and PIPJs
Not usually painful
Can slowly progress over months/years or have a rapid progression since onset

Advice in Primary Care

No evidence splintage or exercise arrests development of contracture
Good practice to avoid gripping over prolonged periods – take regular breaks to stretch the hand and fingers

Actions in Primary Care

Direct Patient to NHS Inform Website for further info - https://www.nhs.uk/conditions/dupuytrens-contracture/
Perform a Heustons Table Top Test i.e. lay hand palm down flat on table.
IF Negative (flat hand - no gaps) – No further action required. Advise patient to monitor Table Top Test regularly.

Referral to Secondary Care

Positive Heustons Table Top Test i.e. unable to lay hand flat , gaps between palm/fingers and table (push a pencil through)
Obvious flexion deformity at either MCPJ / PIPJ or both

Refer via SCI Gateway to Occupational Therapy Hand Clinic and include following in referral:

Description of deformities i.e. flexion of MCPJs or PIPJs
ONLY refer if patient wishes to pursue surgery (Do not wait until finger fully flexed to palm)
Refer urgently if there is a soft tissue lump or swelling which is rapidly increasing in size, painful or has atypical features.
Duration of symptoms

Last reviewed: 23/01/2024

Next review date: 23/01/2025

Version: 1

Reviewer name(s): Jan Beaumont.