This document addresses surgical treatments for Dupuytren’s contracture. Dupuytren's contracture is a painless thickening and fixed tightening (contracture) of the tissue beneath the skin on the palm of the hand and fingers. Progressive contracture may result in deformity and loss of function of the hand.

Clinical Indications

Medically Necessary:

Surgical treatment for Dupuytren’s contracture is considered medically necessary when a palpable palmar cord has been documented to impair the individual’s functional activities and any of the following:

1. Contracture at the proximal interphalangeal (PIP) joint or distal interphalangeal (DIP) joint of 20 degrees or more; or
2. Contracture at the metacarpophalangeal (MP) joint of 20 degrees or more; or
3. Symptomatic Dupuytren’s contracture (that is, pain, tenderness, or functional impairment).

Not Medically Necessary:

Surgical treatment for Dupuytren’s contracture is considered not medically necessary when the criteria above are not met.