Background and Objectives: Dupuytren’s disease (DD) most commonly affects the palm and metacarpophalangeal/proximal interphalangeal joints; distal digital involvement at the distal interphalangeal joint (DIPJ) is uncommon and incompletely characterised. This systematic review summarises reported cases of DD involving the DIPJ, with or without proximal interphalangeal joint (PIPJ) involvement, focusing on clinical patterns, management, and reported outcomes. Materials and Methods: A systematic search of PubMed, Embase, and Scopus from database inception to July 2025 identified published case reports and case series describing DD confined to the DIPJ ± PIPJ of a single digit. Data were extracted on the demographics, digit involvement, anatomic features when reported, interventions, outcomes, complications, recurrence, and follow-up. Results: Nine studies reported 13 patients, published between 1991 and 2023. All patients were male (age range 25–79 years). The little finger predominated (10/13), followed by the ring (2/13) and index finger (1/13). When laterality was described, radial-sided distal cords were common. Surgical fasciectomy was performed in 11 cases and collagenase clostridium histolyticum (CCH) in 2 cases. Where postoperative correction was reported, outcomes were generally favourable; however, joint-specific range-of-motion outcomes and follow-up were inconsistently documented. Follow-up, when reported, ranged from 3 months to 3 years. One recurrence involving the PIPJ was reported 36 months after surgical management. No intraoperative neurovascular or tendon injuries were described, although adverse-event reporting was incomplete in some reports. Conclusions: Reported cases of DD involving the DIPJ most frequently involve the little finger in men. However, the available evidence is limited to a small number of selectively published case reports and series with incomplete outcome and follow-up reporting. These observations should therefore be interpreted cautiously, and comparative effectiveness or durability estimates cannot be established.

Background/Objectives: Open fasciectomy is the standard treatment for Dupuytren’s disease, but recent Australian outcome data are scarce. This study assessed outcomes and predictors of recurrence after open fasciectomy at a tertiary centre. Methods: We retrospectively reviewed all open fasciectomy procedures for Dupuytren’s disease at Peninsula Health, Victoria (January 2023–October 2024). Data included contracture correction, functional scores (URAM, Southampton), recurrence at 6 and 12 months, complications, and demographic predictors. Appropriate statistical tests were used (significance: p < 0.05). Results: Among 152 procedures (mean age 63.8; 70.2% male), contracture correction was significant for all joints. URAM and Southampton scores improved by 15.3 and 7.6 points (p < 0.001). Complications (22.4%) were mainly transient neuropraxia. Recurrence was 10.5% at six months and 13.8% at twelve months. Smoking and female sex increased recurrence risk. Conclusions: Open fasciectomy provides effective correction, functional gain, and low early recurrence rates. Smoking and female sex predict recurrence, supporting tailored counselling and reaffirming open fasciectomy as the standard for advanced Dupuytren’s disease.

Background and Clinical Significance: Dupuytren’s disease (DD) typically affects the palmar fascia and proximal digital structures, with distal interphalangeal joint (DIPJ) involvement considered rare. True extension of DD into the volar pulp has not been previously documented. Distal lesions may be misdiagnosed as neoplastic or inflammatory masses, and optimal management of isolated distal cords remains uncertain. We present the first histologically confirmed case of DD extending beyond the DIPJ into the volar pulp, accompanied by a systematic review of reported DIPJ-dominant DD. Case Presentation: A 30-year-old right-hand-dominant male presented with a two-year history of progressive flexion deformity of the little finger. Examination demonstrated a 90° proximal interphalangeal joint and 55° DIPJ contracture. Ultrasound and MRI showed a well-circumscribed soft-tissue lesion along the radial middle phalanx but did not suggest DD. Open exploration via an ulnar digital approach revealed a discrete DD cord extending distally beyond the DIPJ into the volar pulp, closely associated with the ulnar neurovascular bundle. Limited fasciectomy achieved full correction without neurovascular compromise. Histopathology confirmed classic DD. At the twelve-month follow-up, the patient maintained full extension and function with no recurrence. Conclusions: This study reports the first confirmed case of DD extending into the volar pulp and highlights that atypical distal DD can occur even in young patients. Imaging may fail to identify DD in uncommon sites, reinforcing the importance of clinical suspicion. Limited fasciectomy remains safe and effective in the distal phalanx. Recognition of this phenotype or histopathological examination may improve diagnostic accuracy and guide tailored operative planning.

Dupuytren’s disease (DD) typically affects the palmar fascia and proximal digital structures, with distal interphalangeal joint (DIPJ) involvement considered rare. True extension of DD into the volar pulp has not been previously documented. Distal lesions may be misdiagnosed as neoplastic or inflammatory masses, and optimal management of isolated distal cords remains uncertain. We present the first histologically confirmed case of DD extending beyond the DIPJ into the volar pulp, accompanied by a systematic re-view of reported DIPJ-dominant DD. A 30-year-old right-hand-dominant male presented with a two-year history of progressive flexion deformity of the little finger. Examination demonstrated a 90° proximal inter-phalangeal joint and 55° DIPJ contracture. Ultrasound and MRI showed a well-circumscribed soft-tissue lesion along the radial middle phalanx but did not suggest DD. Open exploration via an ulnar digital approach revealed a discrete DD cord ex-tending distally beyond the DIPJ into the volar pulp, closely associated with the ulnar neurovascular bundle. Limited fasciectomy achieved full correction without neurovas-cular compromise. Histopathology confirmed classic DD. At the twelve-month follow-up, the patient maintained full extension and function with no recurrence. This study reports the first confirmed case of DD extending into the volar pulp and highlights that atypical distal DD can occur even in young patients. Imaging may fail to identify DD in uncommon sites, reinforcing the importance of clinical suspicion. Limited fasciectomy remains safe and effective in the distal phalanx. Recognition of this phenotype may improve diagnostic accuracy and guide tailored operative planning.