What is Dupuytren’s disease?
Dupuytren’s disease is a condition where scar-like tissue forms just beneath the skin of the fingers and the palm of the hand. 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 Dupuytren's disease surgery?
After surgery, your fingers should be straighter and you should be able to make better use of your hand.
Are there any alternatives to surgery?
At present, there is no known cure for Dupuytren’s disease. There is an injection newly available to dissolve the bands of tight tissue but this is not appropriate for all affected hands. To find out more about the injection treatment click here.
What will happen during my hand surgery consultation?
When you meet with your consultant surgeon they'll ensure that you have the opportunity to ask any questions you may have about your hand surgery, they'll discuss with you what'll happen before, during and after the procedure and any pain you might have. Take this time with your consultant surgeon to ensure your mind is put at rest. We know that having an operation of any type can be stressful so we've created a short downloadable guide that you might find useful to print off and use to write down any questions you may have. Do take this with you to your consultation.
What does hand surgery for Dupuytren's diease involve?
Your consultant will explain the options of surgery that are suitable for you – this will depend on the severity of your contractures. This procedure removes the diseased tissue from your palm and digits with the intention of allowing full straightening. Achieving a full correction depends on factors such as the severity of your angle of contracture, the other tissues involved, the length of time the digit has been bent and your post-operative rehabilitation.
There are a variety of different techniques under the umbrella term of fasciectomy. Some are simpler and involve taking away only the diseased fascia under the skin, but sometimes it is necessary to remove the skin as well and a small skin graft will be used to cover the affected area. Your surgeon will talk you through your options and help you decide which is the most appropriate for you.
Needle Fasciotomy. This procedure has had considerable publicity in recent years. It is only appropriate for very specific presentations of Dupuytren’s in the palm of the hand, as it is unsafe and ineffective in the fingers. Your surgeon will be able to advise you whether your Dupuytren’s can be managed with this procedure.
Fasciectomy. This procedure removes the diseased tissue to allow the digits to straighten again. Achieving a full correction depends on a few factors including the timing of the surgery in terms of your disease. There are a variety of different ways a fasciectomy can be carried out. Your surgeon will give you more information about the types of treatment that could work for you and whether they think a full correction is achievable.
What complications can happen?
General complications of any operation:
- Infection in the surgical wound
Specific complications of this operation:
- Injury to the small arteries in a finger
- Incomplete correction of the Dupuytren’s contracture
- Stiffness of the finger joints
- Wound-healing problems
- Rarely, a pain syndrome can result which may cause loss of use of the hand. This is a complication of all hand surgery and not specific to this condition.
How soon will I recover?
You should be able to go home the same day but occasionally a one night stay is recommended.
Post-operative hand therapy and specific exercises will ensure that you make a good recovery and minimise the scar tissue. This is very important as healing scar tissue can also make the fingers contract again. Once you have had surgery or injection treatment you still have Dupuytren’s disease and therefore there is always a chance of the contracture recurring.
It can take some time for your hand to settle down after surgery. The scars can be fairly thick at first.
Paying for your operation
Dupuytren’s surgery costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment, the cost of the operation will be explained and confirmed in writing when you book the operation. You will receive a quote beforehand, and this will includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.
Hand surgery for Dupuytren’s disease should give you a worthwhile improvement in the function of your hand.
For further information you can visit Dupuytren Society at www.dupuytren-online.info.