Dupuytrens Contracture

What is a Dupuytren's Contracture?

Dupytren's Contracture is a fairly common condition that causes the connective tissue that lies beneath the skin of the palm of the hand to contract. The effected connective tissue is technically known as the Palmer Fascia, which normally acts as an anchor to enhance handgrip.

Dupuytren's Contracture is characterised by small painless nodules developing in the palm of the affected hand, followed by impairment of finger function, eventually leading to a complete contraction of the ring and or little finger.

The exact reason this condition develops is not known, although around 60% of patients follow a family history of this disorder. This condition is usually seen more often in men than women, especially in those over 40 years of age and especially in those of North European origin.

Dupuytren's Contracture is usually painless, although it causes considerable inconvenience and irritation in those who suffer with a contracture deformity.

How is a Dupuytren's Contracture treated?

This first line of treatment for a patient experiencing early symptoms of a Dupuytren's Contracture, such as showing signs of the nodule development; is to simply wait and observe the situation. It is only when the condition progresses and leads to any finger contracture and deformity that surgery is indicated.

How is a Dupuytren's Contracture repair procedure carried out?

The surgical procedure to correct a Dupuytren's Contracture is known as a Fasciectomy.

A Fasciectomy can be performed under General Anaesthetic (you will be asleep) or Regional Anaesthetic (you will be awake, but the hand and fingers will be completely numb throughout the procedure). The procedure usually takes only a short amount of time to perform (approximately 30 minutes) for a single contracture, although more complex and longstanding contractures can prove lengthier to perform. Most procedures are provided on a Day-Case basis.

During a traditional Fasciectomy the surgeon will make a small zigzag shaped incision (cut) on the skin directly above the contracted finger joint and then expose and debulk (remove the abnormal tissue) of the fascia. This will be followed by surgically releasing any overlying skin that remains attached to the fascia.

Once the Fasciectomy is complete, the wound or wounds will be closed with absorbable sutures (stitches) and covered with a light dressing and plaster cast to support and hold the fingers and hand in a correct healing position.

What is the recovery like?

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid complications such as joint stiffness and Deep Vein Thrombosis from developing. It is therefore normal for patients to be encouraged to undertake upper limb physiotherapy exercise immediately after surgery.

Following a progressive improvement of mobility and pain control, patients are normally discharged home 4-6 hours after their surgery.

The plaster cast dressing is usually removed after 5 days and replaced with a light night support splint in order to encourage mobilisation and exercise of the affected fingers in the day, but provide corrective support at night.

During the next 6 weeks patients will be expected to work on improving their hand and finger range of movement through progressive physiotherapy. Your Consultant Surgeon will then assess your condition after six weeks to evaluate how successful the Fasciectomy has been.

Patients who are in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work.

Are there any risks associated Dupuytren's Contracture surgery?

The main risk associated with this condition is related to the risk of reoccurrence or the new development of another contracture. Although Fasciectomy procedures to correct Dupuytren's Contracture are regularly performed without any complication, it is important that all candidates are fully aware of both the benefits and risks of undertaking specialist hand surgery of this kind.

All surgery, no mater how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation to discuss your condition in relation to these risks cannot be over emphasised.

How do I find out if I am a suitable candidate for Dupuytren's Contracture surgery?

Surgical Advisor will be delighted to help you find a leading expert in Hand and Wrist surgery to consult with. Your surgeon will carry out a thorough evaluation of your condition and provide you with a comprehensive explanation of the most appropriate surgical solution.
 
Our Expert Consultant Orthopaedic Surgeons are most carefully selected and recommended because they understand the importance of the decision you are making when contemplating complex Hand and Wrist surgery and because of their specialist upper limb surgery expertise. Throughout your consultation you will therefore be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment.

To ensure that patients are comfortable with any recommendations or advice given in their consultation, all patients are asked to go away after a consultation and think through all the information they have received. If for whatever reason you are still not sure about the best course of action and wish to have further dialogue with your surgeon, you will not be expected to pay for a second consultation appointment.

How do I make a consultation appointment?

For further advice on how to make an appointment to consult with an expert Hand and Wrist surgeon who specialises in Dupuyren's Contracture surgery: 

Please call Surgical Advisor on: 0870 41 41 41 2
Or email us by clicking on: advice@surgicaladvisor.com