I've had Dupuytren's disease of both hands for two years. The left hand is much worse than the right. The doctor has suggested surgery to remove the nodules. When is surgery advised?

Nodules associated with Dupuytren's disease can progress to become cords of thick, tight palmar fascia. The joints can get contracted or "stuck" in one position. The patient is unable to fully straighten the finger.

Some people decide to have elective surgery to remove the nodules. Others wait until contractures cause pain, loss of motion, and loss of function. It's not clear yet if it makes a difference in outcomes as to when the surgery is done.

The nodules return in about 60 percent of patients who have surgery to remove them. There doesn't seem to be any way yet to predict which patients will have a good outcome and who will have disease recurrence.