Dupuytren Surgery
Dupuytren's Contracture
Dupuytren’s contracture is a hand deformity that develops over years, involving the thickening and contracting of the fibrous layer of connective tissue beneath the skin of the palm and fingers, known as the fascia. As the fascia, or ligament, thickens into tough cords and contracts over time, the fingers may be drawn towards the palm, making it difficult to straighten the affected fingers, at which point we speak of a contracture. The disease varies individually, initially forming nodules (lumps and dimples that attach to the skin above) and then cords (with the nodules’ thickening contributing to the development of dense and hard subcutaneous tissue strands) until the final stage when these tissues cause tension beneath the skin, limiting finger straightening.
What are the Benefits of Dupuytren's Surgery?
Dupuytren’s surgery can help straighten the fingers affected by Dupuytren’s contracture and improve hand function.
What Does Dupuytren's Surgery Involve?
Surgery for Dupuytren’s contracture loosens or removes the thickened tissue of the palm and fingers.
The surgical options include:
- Open or needle aponeurotomy
An outpatient procedure performed under local anesthesia, where a sharp blade or a very fine needle is inserted into the fibrous bands of the palm or fingers to separate the thickened connective tissue and relieve the contraction causing tension in the palm.
- Dupuytren's contracture surgery
A surgical procedure performed under general anesthesia. The contracted aponeurosis is completely removed along the affected digit, preserving the blood vessels and nerves using microsurgical techniques. The wounds can usually be closed directly, but sometimes skin grafting may be necessary.
The main types of palmar fascia removal are: segmental (removing short segments of the band through one or more small incisions), regional (removing the entire band through a single longer incision), and dermofasciectomy (removing the band and the skin above it, requiring skin grafting).
When is Dupuytren's Surgery Needed?
When the contracture becomes moderate or severe, Dupuytren’s surgery is recommended to reduce the contracture and improve the movement of the affected fingers. Surgery is advisable when it becomes impossible to lay your hand flat on a table.
Aftercare
For good recovery and to minimize scar tissue, specialized hand therapy may be needed to improve hand function and range of motion, such as physical therapy, massage, and exercises led by a physiotherapist. Initially, you may need to wear a hand splint. It may take some time for hand function to be restored following Dupuytren’s surgery. We welcome you to our clinic, where in our modern facility, Dr. Péter Vancsó, our chief hand surgeon, will take care of your recovery.
