Policy number: SRP 040
Policy name: Dupuytren’s Contracture in adults
Status: Individual Funding Approval
Effective date: 1 April 2024
Next review date: 1 April 2026
Mid and South Essex ICB commissions treatment for Dupuytren’s Contracture on a restricted basis.
Dupuytren’s Contracture is nodular or cord-like thickening of the palmar fascia causing a tethering of the digits and a loss of range of extension.
Treatment is not indicated in cases where there is no contracture, in patients with a mild (less than 20°) contractures or one which is not progressing and does not impair function.
An intervention (needle fasciotomy, fasciectomy and dermofasciectomy) should be considered for:
- finger contractures causing loss of finger extension of 30° or more at the metacarpophalangeal joint or 20° at the proximal interphalangeal.
OR
- severe thumb contractures which interfere with function
For audit purposes, the referral letter must detail loss of extension and functional impairment.
The following surgery/treatments are considered to be a low clinical priority and are not routinely funded.
- Radiation therapy for early Dupuytren’s contracture
- Simple nodules in the palm
Funding for patients not meeting the above criteria will only be granted in clinically exceptional circumstances.
Individual funding requests should only be made where the patient demonstrates clinical exceptionality.
Find out more information on applying for funding in exceptional clinical circumstances
References:
Dupuytren’s contracture release in adults Evidence Based Interventions Programme