Dupuytren’s Disease
Dupuytren's disease is a condition that affects the connective tissue in the palm of the hand and fingers, causing the fingers to bend towards the palm, and in some cases, become fixed in place. This can make it difficult to perform daily activities.
The surgical procedure for Dupuytren's disease- fasciectomy- involves removing the thickened tissue and straightening the fingers. The procedure is usually performed under general anesthesia and typically takes a few hours to complete depending on the severity.
After surgery, patients will need to wear a splint for several weeks to allow the hand to heal properly. Hand therapy is also recommended to help restore hand function and flexibility. Recovery time varies depending on the extent of the surgery, but most patients can expect to resume normal activities within a few months.
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FAQs
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After your surgery your hand will be wrapped in a bandage and often a half cast splint will be applied. Your wounds will be inspected at the one-week mark and if everything is healing nicely you will be allowed to wash the hand in the shower from that point. Usually the wounds are healed by the end of 2-3 weeks and you are getting back to normal hand use by week 4-6.
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The trade-offs for dupuytren’s surgery are the down-time whilst recovering from surgery and the scars on the palm which will be permanent. In addition, even after a successful operation, it is not uncommon for the disease to gradually recur over time.
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The risks of Dupuytren’s surgery are as follows:
• Wounds may be slow to heal resulting in a long period of dressings (this is more common in smokers and people with diabetes).
• Wounds may become infected requiring antibiotics or further surgery
• Scars may become thickened and painful
• In rare cases, global pain of the hand can develop which can be difficult to treat (so-called complex regional pain syndromes)
• Damage to the digital nerves may occur (approximately 1-5%, worse in severe disease and re-do surgery) resulting in permanent numbness or altered sensation on the fingers.
• In very rare cases (severe contracture, re-do surgery) the blood vessels supplying blood to the fingers can be damaged resulting in loss of fingers
• In severe long-standing contracture, it may not be possible to achieve full straightening of the fingers.