For Dupuytren disease with mild contracture, which initial management is appropriate?

• A. Collagenase injection
• B. Observation
• C. Surgical fasciectomy
• D. Radiation therapy

Answer: (B)

Mild Dupuytren disease often progresses slowly and may not affect hand function initially. Because invasive treatments carry risks, a watchful waiting approach is appropriate to avoid unnecessary procedures when the contracture is minimal and not functionally limiting. Regular follow-up allows you to monitor progression and intervene later if the contracture worsens or causes functional impairment.

Collagenase injections can release cords but are typically considered when there is a more established contracture with functional impact, not at the mild stage. Surgical fasciectomy is more invasive and reserved for significant, functionally limiting contractures. Radiation therapy has limited and inconsistent evidence for preventing progression and is not a standard initial choice for mild disease.