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Tubiana classification (Dupuytren)

Grades Dupuytren contracture in each ray by summing the finger-joint extension deficits.

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Method · Limits of application

Tubiana 1986: total extension deficit, classes 0/N/I–IV, cutoffs 45/90/135 degrees

The Tubiana 1986 classification describes Dupuytren deformities by ray and provides for additional information on the thumb, first web space, skin and postoperative stiffness. The extension-deficit total alone does not reproduce this complete assessment. Cutoffs and conventions for the version used must be checked in the full article.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

MCP extension deficit (metacarpophalangeal) · degrees
PIP extension deficit (proximal interphalangeal) · degrees
DIP extension deficit (or hyperextension) · degrees
Is there a palpable nodule or cord?

4/4 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Total ray deficit = MCP + PIP + DIP extension deficit (DIP hyperextension counts as a deficit). Stages: 0 no lesion; N nodule without contracture; 1 up to 45°; 2 45–90°; 3 90–135°; 4 above 135°.

References

Tubiana R. Evaluation des déformations dans la maladie de Dupuytren (Evaluation of deformities in Dupuytren disease). Ann Chir Main, 1986.

Identifier: classificacao-de-tubiana

Original clinical content: Brazilian Portuguese.

Method version

Tubiana 1986: total extension deficit, classes 0/N/I–IV, cutoffs 45/90/135 degrees

classificacao-de-tubiana@native-2026-10-05+f8d39859e49a

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (4)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

MCP extension deficit (metacarpophalangeal): 30 degrees
PIP extension deficit (proximal interphalangeal): 0 degrees
DIP extension deficit (or hyperextension): 0 degrees
Is there a palpable nodule or cord?: Yes

{
  "mcf": 30,
  "ifp": 0,
  "ifd": 0,
  "nodulo": "1"
}

Expected result

{
  "total": 30,
  "estadio": "1"
}

Actual result

{
  "total": 30,
  "estadio": "1"
}

Case 2

reference-002

Inputs

MCP extension deficit (metacarpophalangeal): 40 degrees
PIP extension deficit (proximal interphalangeal): 50 degrees
DIP extension deficit (or hyperextension): 0 degrees
Is there a palpable nodule or cord?: Yes

{
  "mcf": 40,
  "ifp": 50,
  "ifd": 0,
  "nodulo": "1"
}

Expected result

{
  "total": 90,
  "estadio": "2"
}

Actual result

{
  "total": 90,
  "estadio": "2"
}

Case 3

reference-003

Inputs

MCP extension deficit (metacarpophalangeal): 60 degrees
PIP extension deficit (proximal interphalangeal): 70 degrees
DIP extension deficit (or hyperextension): 20 degrees
Is there a palpable nodule or cord?: Yes

{
  "mcf": 60,
  "ifp": 70,
  "ifd": 20,
  "nodulo": "1"
}

Expected result

{
  "total": 150,
  "estadio": "4"
}

Actual result

{
  "total": 150,
  "estadio": "4"
}

Case 4

reference-004

Inputs

MCP extension deficit (metacarpophalangeal): 0 degrees
PIP extension deficit (proximal interphalangeal): 0 degrees
DIP extension deficit (or hyperextension): 0 degrees
Is there a palpable nodule or cord?: Yes

{
  "mcf": 0,
  "ifp": 0,
  "ifd": 0,
  "nodulo": "1"
}

Expected result

{
  "total": 0,
  "estadio": "N"
}

Actual result

{
  "total": 0,
  "estadio": "N"
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

README

Local installation

Code license: Apache-2.0

Guidelines and conditions

This repository’s license applies to the code. Third-party instruments, questionnaires, data and models remain subject to their owners’ conditions.

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.