Dupuytren’s disease is a genetic condition involving a fixed contracture of the hand which results in the inability to straighten the fingers, often the two smallest fingers. Tight bands develop in the palm and/or fingers which progressively cause the fingers to curl inwards. This can cause pain, and in severe cases skin hygiene problems.
Surgery involves removal on the bands of fibrous tissue in the palm and fingers, release of the affected joints, followed by lengthening of the skin with either skin flaps or skin grafts. This helps improve finger position and discomfort.
There is a non-surgical option now available, known as a collagenase injection. This involves an injection into the fibrous tissue which helps to dissolve the fibrous bands. It is done in 2 stages – the initial injection, and then manipulation of the fibrous bands and finger 1-2 days later which causes multiples fractures in the band. This option causes the bands to break in multiple sections, helping to release the contracture, however does not completely dissolve the fibrous tissue.
Those who have diagnosed Dupuytren’s disease and the contracture is causing functional problems, pain, discomfort and concern with appearance.
It is likely you will achieve immediate improvement in your finger and hand position, as well as function. It is important to remain realistic in your outcome as Dupuytren’s disease may recur over time, however it could be years or even decades.
During your initial consultation your surgeon will determine the site of the contracture, discuss any symptoms you have such as pain and discomfort, expectations you have, questions about the procedure, medical history and current medication. We will provide as much information as possible so that you feel comfortable and informed.
Please ensure you have arranged someone to drive you home after your surgery and to help you out at home for a few days. To reduce risk of bleeding and bruising please make sure to:
We will guide you to prepare for surgery so that your procedure and recovery go smoothly.
Dupuytren’s disease surgery is performed under general anesthetic or an arm block where only your arm is anesthetized. The collagenase injection can be performed either under local anaesthetic or sedation. Whichever is used, you will be very comfortable and experience no pain during the surgery.
During the procedure, excision of the fibrous bands is made with great care as the nerves are located directly next to the bands. The joints of the fingers may also need releasing, as well as lengthening of any tight skin on the fingers by performing skin flaps or grafts. The incision is sutured and dressings applied. Simple procedures take approximately 30 minutes or up to 2 hours for a more complex operation, and you will likely be able to go home that day.
As with any surgery there are some risks involved such as:
Please call our office if you experience any of the following: excessive pain or bleeding, abnormal swelling or fever during the first 24 hours.
To best prepare for our initial conversation and to better understand your goals, please fill out the form and we will be in touch with you to confirm the availability of your preferred surgeon.
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