What is Dupuytren’s disease?

Dupuytren’s disease is a condition where scar-like tissue forms just beneath the skin of your fingers and the palm of your hand. It mainly affects the ring and little fingers.

Over time, this fibrous tissue can contract and force one or more fingers to curl up into the palm. This is known as Dupuytren’s contracture.

What are the benefits of surgery?

You should be able to make better use of your hand and straighten the affected fingers more.

Are there any alternatives to a Dupuytren’s fasciectomy?

Your surgeon may be able to perform a needle aponeurotomy. This involves cutting the bands in your hand using a needle and a local anaesthetic, and avoids making a larger cut on your skin. However, there is a higher risk of the contracture coming back.

What will happen if I decide not to have the operation?

The condition will often get slowly worse with time and can result in one or more fingers being held bent into the palm. If this is left untreated, your finger joints may become permanently stiff.

What does the operation involve?

The surgery can range from simply cutting a fibrous band in the palm of your hand to removing all the affected skin and replacing it with skin grafts.

Various anaesthetic techniques are possible.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious.

General complications of any operation

• Bleeding after the operation.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Chest infection — your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Injury to an artery in your finger. If both main arteries get damaged, you may lose your finger.
• Incomplete correction of the Dupuytren’s contracture.
• Return of Dupuytren's disease.
• Stiffness of your finger joints.
• Damage to your nerves. This usually improves with time but you may not completely recover normal feeling.
• Numbness in your fingers which have been operated on. This is common and usually gets better after about 6 weeks. However, the numbness can be permanent. Your fingers may also be sensitive to cold.
• Wound-healing problems. Sometimes a small area of skin dies.
• Severe pain, stiffness and loss of use of your hand. Your hand can take months or years to improve. Sometimes there is permanent pain and stiffness.

Consequences of this procedure

• pain
• scarring of your skin

How soon will I recover?

You should be able to go home the same day.

Your surgeon may arrange for you to have a splint to wear on your hand at night, and some physiotherapy to help get your fingers moving again.

It is also important to exercise your shoulder and elbow gently to prevent stiffness.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

It can take some time for your hand to settle.

Your fingers may curl up into your palm again in the future.

Summary

A Dupuytren’s fasciectomy should straighten your fingers and give you a worthwhile improvement in the function of your hand.

IMPORTANT INFORMATION

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