Dupuytren’s disease, also known as Dupuytren’s contracture, is a progressive connective tissue disorder that affects the hand. It causes the fascia, a fibrous tissue layer in the palm, to become thick and tight, leading to the curling of one or more fingers towards the palm. This condition can significantly limit hand function.
To address severely bent fingers caused by Dupuytren’s contracture, individuals may undergo a surgical procedure called a fasciectomy. During this procedure, an orthopaedic hand surgeon removes the thickened and tight fascia tissue in the palm. While surgery is not a cure, it can greatly improve the ability to straighten and move the affected fingers, restoring hand function.
Dupuytren’s disease may result from inherited genetic mutations or occur for unknown reasons. It typically starts with the development of nodules or small tissue lumps on the palm’s fascia, which eventually progress into thick cords of tissue that pull the fingers (and occasionally the thumb) towards the palm. Surgical fasciectomy is an effective treatment option for those with severe Dupuytren’s contracture, offering relief and improved hand mobility.
Fasciectomy procedures encompass various methods, each dependent on specific cases:
Dupuytren’s disease is a chronic and progressive condition. In the initial stages, non-surgical treatments are typically explored by your healthcare provider, which may involve injections of steroids or collagenase, an enzyme. However, if the condition advances to the point where your fingers experience severe bending, significantly impacting the functionality of your hand, your healthcare provider may initiate discussions about surgical interventions.
Surgical treatments for Dupuytren’s disease include the following options:
Your healthcare provider will determine the most appropriate surgical approach based on the severity and progression of Dupuytren’s disease.
It’s typical to experience some numbness or loss of feeling in your fingers following a fasciectomy. As the constricted nerves start to extend, this short-term issue ought to get better. Very rarely, injury to surrounding blood vessels or nerves may result in irreversible loss of finger function. Amputation may be necessary for you.
The following are other possible fasciectomy side effects:
You should adhere to the pre-procedural guidelines provided by your surgeon. It could be necessary for you to:
A segmental fasciectomy is typically performed as an outpatient procedure, allowing patients to return home on the same day. Regional anesthesia may be administered to numb the upper body, and in some cases, the surgeon may opt not to use stitches, leaving a small wound open for natural drainage and healing while applying a bandage to minimize infection risks. On the other hand, subtotal palmar fasciectomies and dermofasciectomies are more complex and may necessitate skin grafts, often requiring general anesthesia for the patient to be asleep during the surgery. Due to the higher risk of infection associated with skin grafts, individuals undergoing these procedures may need to stay overnight in the hospital.
After undergoing surgery, it’s common to experience some post-operative symptoms such as pain, swelling, and stiffness. Additionally, you may encounter tingling or numbness in your hand and fingers, which could persist for several months. The duration of time you’ll need to take off work varies depending on your occupation, ranging from two to 12 weeks.
To ensure a smooth recovery, it’s essential to adhere to your healthcare provider’s recommendations, which may involve the following:
While surgery doesn’t provide a cure for Dupuytren’s contracture, it can enhance hand function. Roughly 20% of individuals may encounter a reoccurrence of the condition following a fasciectomy, which may necessitate additional surgical intervention.
It is advisable to reach out to your healthcare provider promptly if you encounter any of the following symptoms:
+66 2066 8888