Dupuytren’s contracture is a hand deformity that occurs when the tissue beneath the skin of the palm becomes thick and tight, causing one or more fingers to curl inward. This condition usually affects the ring and little fingers, but it can also affect the middle finger.
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Dupuytren’s contracture repair benefits:
Improved hand function
Restored hand appearance
Symptoms of Dupuytren’s contracture can vary in severity but typically include a thickened and puckered skin on the palm of the hand, as well as a firm lump or cord that can be felt beneath the skin. Pits in the palm can also occur early in Dupuytren’s disease. As the condition progresses, one or more fingers may become progressively bent or curled, making it difficult to perform everyday tasks such as grasping objects or typing. Some patients will also have nodules on the bottom of their feet or other associated symptoms.
The exact cause of Dupuytren’s contracture is unknown, but it is more common in men over the age of 40, in individuals of Northern European ancestry, and in individuals with a family history of the condition. It is not caused by activity or lifestyle choices.
Treatment options for Dupuytren’s contracture depend on the severity of the condition and the degree of impairment it causes. In mild cases, observation may be recommended. However, if the deformity is more severe, treatment may include splinting or the use of a device to stretch the affected finger or fingers. Collagenase injections may also be recommended to dissolve the cord that is causing the finger to curl. If the condition is more advanced or if other treatments are not effective, then surgical intervention is typically necessary. During this quick procedure, the thickened tissue and/or tight bands of tissue that are causing the finger to curl are removed. We perform outpatient fasciectomies to treat Dupuytren’s contracture at our accredited surgery center in Flagstaff, Arizona.
Dupuytren’s Contracture Repair Benefits
Dupuytren’s contracture repair can improve hand function, relieve pain and discomfort, and improve the appearance of the hand. By releasing the tight cords or bands of tissue that are causing the fingers to curl, repair surgery can restore the ability to grasp objects, use tools, and perform daily tasks. In more severe cases, surgery can prevent the progression of the disease, which can lead to worsening deformity and disability over time.
It is important to note that like any surgery, Dupuytren’s contracture repair carries some risks, such as infection, bleeding, and nerve damage. Patients should discuss the potential benefits and risks of surgery with their healthcare provider to determine if repair surgery is the right choice for them.
Medical Review: This procedural information has been medically reviewed by plastic and reconstructive surgeon, Brian A. Cripe, M.D.
Fasciectomy Recovery and Aftercare
After your Dupuytren’s contracture fasciectomy, your hand may be swollen for a few days and you may feel numbness or tingling near your incision. Most patients can return to work within a week, depending on their job. If your work requires you to put pressure on the hand and use the affected fingers repeatedly, you may need more time off to ensure a full recovery. Your surgeon will help determine your recovery period.
To optimize healing, we ask our patients to follow these recovery guidelines after their procedure. If you notice increased redness, discharge, or pain near your incision, please give us a call right away.
Incision Aftercare: Avoid using your hand until a week or two after surgery. This includes lifting anything heavier than a few pounds, doing repeated finger movements, computer work, and using the hand to grasp objects. Do not get your hand wet for the first 24 hours and avoid submerging your hand in water for four to six weeks after the procedure to prevent infection. It’s important to keep your incision area dry and clean.
Ice and Elevation: Apply a cold compress to your hand for 10 – 20 minutes, every few hours when you’re awake. Keep your hand above your heart by resting it on a pillow for the first few days after surgery to help reduce swelling.
Hand Therapy: We’ll provide you with exercises to do at home to help your fingers become more flexible and promote proper healing.
Splint: In some cases, we’ll provide a splint for you to wear to help prevent the hand from being injured after the procedure.
Medications: We may give you a pain medication script to help you feel more comfortable.
Exercise: Going on easy walks as soon as you feel well enough is recommended, but please don’t push yourself – especially for the first few weeks after surgery. By six weeks after surgery, most patients feel ready to resume all of their pre-operative activities, including high-intensity exercise and weight lifting.
Dupuytren’s disease is a progressive condition that impacts the fascia, which is the tissue beneath the skin. The fascia’s role is to keep the skin of the palm firmly in place, preventing it from sliding when holding or grasping objects. As the disease progresses, tough scar tissue forms on the fascia, causing the fingers to bend and become impossible to straighten.
There is no cure for Dupuytren’s disease, but it can be effectively treated with injections and surgery to disable the tightened cord that causes the finger to curl. The condition may reoccur after treatment in roughly 20% of patients.
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