Status: Individual funding approval
Effective date: 1 April 2026
Next review date: 1 April 2029
Essex ICB commissions treatment for Dupuytren’s Contracture in adults 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 when any of the following apply:
- there is no contracture
- the contracture is mild (<20°)
- the contracture is not progressing
- the contracture does not impair function
Intervention (needle fasciotomy, fasciectomy or dermofasciectomy) may be considered when one of the following applies:
- Loss of finger extension ≥30° at the metacarpophalangeal joint,
or
- Loss ≥20° at the proximal interphalangeal joint,
or - Severe thumb contracture interfering with hand function.
For audit purposes, referral must document:
- the degree of extension loss, and
- the specific functional impairment.
The following treatments are NOT routinely funded:
- Radiotherapy for early Dupuytren’s
- Collagenase injections (no longer available; NICE TA459 withdrawn)
- Treatment of simple palmar nodules
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.
Further information on applying for funding in exceptional clinical circumstances can be found by visiting the ICB’s website.
References:
Dupuytren’s contracture release in adults Evidence Based Interventions Programme