Dupuytren’s contracture

Specialty: General surgery
Age group: Adult

Criteria for referral to public hospital service

• Skin breakdown or infection, or both, secondary to severe contracture
• Metacarpophalangeal (MCP) joint flexion contracture greater than 30 degrees with functional impairment
• Proximal interphalangeal (PIP) joint flexion contracture greater than 10 degrees with functional impairment
• Recurrence of contracture after surgery with functional impairment.

Information to be included in the referral

Information that must be provided

• Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
• Range of measurement (ROM) measurements
• Details of functional impairment and how symptoms are impacting on daily activities including impact on work, study or carer role
• Details of previous medical and non-medical management including the course of treatments and outcome of treatments
• If referral relates to recurrence after surgery, details of the surgery including when and where procedure(s) were performed
• History of smoking
• If the patient is taking an anticoagulant medicine
• Statement about the patient’s interest in having surgical treatment if that is a possible intervention.

Provide if available

• If the person identifies as an Aboriginal and/or Torres Strait Islander
• If the person is part of a vulnerable population.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Vulnerable populations include:

• people from culturally and linguistically diverse backgrounds
• older Australians
• carers of people with chronic conditions
• people experiencing socio-economic disadvantage
• people living in remote, or rural and regional locations
• people with a disability
• people with mental illness
• people who are, or have been, incarcerated.

Vulnerable patient groups also include terminally ill patients, patients with experiences of family violence, in out-of-home care, foster care and those in state care.

Referral to a public hospital is not appropriate for

• Palmar thickening or nodules without contracture
• Contracture without functional impairment
• Metacarpophalangeal (MCP) joint flexion contracture less than or equal to 30 degrees
• Proximal interphalangeal joint (PIP) joint flexion contracture less than or equal to 10 degrees