If the hand cannot be placed completely flat on the table, leaving a space between the table and a part of the hand as big as the diameter of a ballpoint pen, the test is considered positive and surgery or other treatment may be indicated. Additionally, finger joints may become fixed and rigid. There are several types of treatment, with some hands needing repeated treatment.The main categories listed by the International Dupuytren Society in order of stage of disease are radiation therapy, needle aponeurotomy (NA), collagenase injection, and hand surgery. As of 2016 the evidence on the efficacy of radiation therapy was considered inadequate in quantity and quality, and difficult to interpret because of uncertainty about the natural history of Dupuytrens disease.Needle aponeurotomy is most effective for Stages I and II, covering 6–90 degrees of deformation of the finger. However, it is also used at other stages. Collagenase injection is likewise most effective for Stages I and II. However, it is also used at other stages.Hand surgery is effective at stage I to stage IV. Surgery
On 12 June 1831, Dupuytren performed a surgical procedure on a person with contracture of the 4th and 5th digits who had been previously told by other surgeons that the only remedy was cutting the flexor tendons. He described the condition and the operation in The Lancet in 1834 after presenting it in 1833, and posthumously in 1836 in a French publication by Hôtel-Dieu de Paris. The procedure he described was a minimally invasive needle procedure.
Normally, the palmar fascia consists of collagen type I, but in Dupuytren patients, the collagen changes to collagen type III, which is significantly thicker than collagen type I. Related conditions
People with severe involvement often show lumps on the back of their finger joints (called "Garrods pads", "knuckle pads", or "dorsal Dupuytren nodules"), and lumps in the arch of the feet (plantar fibromatosis or Ledderhose disease). In severe cases, the area where the palm meets the wrist may develop lumps. It is thought the condition Peyronies disease is related to Dupuytrens contracture. Risk factors
Dupuytrens contracture is a non-specific condition, but primarily affects:

Non-modifiable
People of Scandinavian or Northern European ancestry; it has been called the "Viking disease", though it is also widespread in some Mediterranean countries, e.g., Spain and Bosnia. Dupuytrens is unusual among groups such as Chinese and Africans. Men rather than women; men are more likely to develop the condition (80%)
People over the age of 50 (5% to 15% of men in that group in the US); the likelihood of getting Dupuytrens disease increases with age
People with a family history (60% to 70% of those affected have a genetic predisposition to Dupuytrens contracture)

Modifiable
Smokers, especially those who smoke 25 cigarettes or more a day
Thinner people, i.e., those with a lower-than-average body mass index.