Contractures of the fingers and hand


A contracture is when a joint is unable to fully move through its full range of movement. There are broadly speaking 2 types of contracture; one is where the joint can be taken through its full range manually using your other hand (passive movement). This is called a correctable contracture. The other type is a fixed contracture; this is when the joint cannot be taken through its full range by passive movement. A contracture can affect either the ability to bend or straighten a joint, or both.


There are many causes of contractures. Injury, Arthritis and Dupuytren's disease are probably the commonest causes.

Mr Miranda advises that should you develop a contracture after injury, you should seek treatment urgently as in many cases that can be treated successfully by non-surgical means if seen early. 


The symptom that defines the condition is loss of range of movement of a joint. The underlying cause may also cause additional symptoms, such as pain, swelling, skin nodules and deformity.


Mr Miranda will go through the history of how long you have had the contracture, predisposing causes, injury, other medical conditions, etc. An examination and measurement of the range of the diseased joint and the normal joints will also be performed.

Additional tests, most commonly an X-ray of the affected joint is required.


Non-surgical Treatment

Depending on the cause of the contracture, almost always some sessions with the hand therapist is required. This will involves a splinting and a stretching program. Even if this does not fully correct the contracture, it will make recovery from subsequent surgical treatment easier for you. It will also familiarise you with the necessary rehabilitation program  following surgery.

Surgical Treatment

This option is for when the non-surgical program has failed to correct the contracture to a satisfactory level. This point is mostly determined by you as to whether the contracture is causing a nuisance with your everyday, occupational or recreational activities.

The operation to release the contracture is called an arthrolysis. Depending on the cause and the severity of the condition it may be performed under local, regional  or general  anaesthetic 

Again depending on the cause for the contracture, additional procedures with the arthrolysis may be required. For example, in Dupuytren's disease removal of the fibrous cord is also required to correct the contracture.  If arthritis is the cause of the contracture, then the treatment is directed to the arthritis.

As this is a complex hand condition, you should seek a consultation  with a specialist hand surgeon.  Mr Miranda has extensive experience in dealing with this condition and can discuss the options and his results with you.