admin Title: Dupuytren’s and Recurrence: Why the Disease Comes Back
Categories: Dupuytren’s Contracture • Recurrence • Surgery • Treatment Challenges
Keywords: Dupuytren’s contracture, recurrence, surgery, treatment outcomes, fibroblasts, collagen, genetics, contracture return
Slug: dupuytrens-recurrence
Meta Description: Recurrence is common after Dupuytren’s treatment. Learn why fibroblasts keep producing collagen and how to manage contracture return.
Source & Link: Hand Clin. 2018; 34(3):345–356. PMC6122315
License: CC-BY 4.0
Dupuytren’s and Recurrence: Why the Disease Comes Back
Introduction
Dupuytren’s contracture often returns even after successful surgery or injections.
Recurrence reflects persistent fibroblast activity and the body’s ongoing fibrotic response.
Definition and Mechanism
Recurrence = return of fibrotic cords or contractures after improvement.
Abnormal fibroblasts remain active post-treatment, producing collagen and triggering new nodules.
The palmar environment continues to release growth factors that stimulate fibrosis.
Causes / Risk Factors
Genetics: Inherited fibroblast overactivity.
Age: Younger patients → more recurrence.
Severity: Extensive disease returns faster.
Lifestyle: Smoking and diabetes impair healing.
Treatment type: Needle and enzyme methods recur sooner than open surgery.
Symptoms of Recurrence
New lumps, puckering, and loss of extension resemble original disease.
Early reporting allows timely intervention and hand therapy adjustment.
Diagnosis / Research Summary
Recurrence is diagnosed clinically; ultrasound can differentiate scar from new fibrosis.
Rates range 20–60 % depending on procedure.
Molecular research shows fibroblast gene activation persists even after cord removal.
Treatments / Patient Tips
Repeat fasciectomy or dermofasciectomy: More durable results.
Needle aponeurotomy / collagenase injections: Less invasive but recur sooner.
Hand therapy & splinting: Maintain mobility.
Lifestyle: Quit smoking, manage diabetes, stay active.
What the Science Says
Fibroblasts retain a “memory” of fibrosis, making Dupuytren’s systemic rather than local.
Future therapies may target TGF-β pathways or gene regulation to prevent recurrence.
Why It Matters
Recurrence is not treatment failure—it’s part of the disease cycle.
Awareness and follow-up care reduce impact and preserve function.
Key Takeaways
Recurrence is common: 20–60 % after treatment.
Fibroblasts drive return: Persistent collagen production.
Multiple factors: Genetics, age, lifestyle.
Early monitoring: Detect new nodules fast.
Long-term management: Therapy + healthy habits = best outcomes.
Legal & Medical Disclaimer: This content is for informational purposes only and not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider. Dupuytren’s Solutions is an educational resource to support —not replace— professional care. Individual results may vary.
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Attribution (CC BY 4.0): Adapted from Werker P et al., Hand Clin. 2018; 34(3):345–356. Source
