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Treatment Options for Dupuytren’s Contracture

Surgery for Dupuytren's Contracture

What if it becomes difficult for you to grasp objects or perform other daily activities? Your health care provider may recommend surgery if your disease progresses. The goal of surgery is to restore motion in your fingers.

Open Surgery
The surgeon makes an incision and either divides (fasciotomy) or removes (fasciectomy) part or all of the thickened bands of tissue.

A variety of techniques are used to close the wound. Sometimes a skin graft is needed for the incision to completely heal. To do this, the surgeon takes healthy skin from another area of the body and attaches it to the area in the hand that needs to be closed.

Needle Aponeurotomy
An alternative to open surgery is an office procedure called needle aponeurotomy. The surgeon uses a hypodermic needle to divide and cut the diseased tissue in the palm and fingers.

This procedure is less invasive and leads to a quicker recovery than open surgery. Many do not need rehabilitation with physical therapy following the procedure. A presurgical evaluation can determine whether you are a candidate for this procedure.

What to Expect After Surgery
Surgery may be able to correct the changes of Dupuytren’s if only one of the knuckles connecting the finger to the hand is involved.

If two or more fingers are involved in this joint, it is more difficult to correct the contraction. For other joints of the fingers, surgery may improve but not correct the limitations caused by this disease.

Potential Complications
Both open surgery and needle aponeurotomy have a high rate of recurrence of contractures. Also, open surgery can lead to an exaggerated reaction to the wound.

Other complications of surgery include:

  • Swelling and soreness
  • Injury to nerves or blood vessels
  • Infection
  • Tissue death

Speeding Recovery
After surgery, it may help to elevate your hand above your heart and gently move your fingers. This may help relieve pain, swelling, and stiffness.

Your doctor may refer you to a physical therapist. Your therapist can teach you exercises to improve strength and function and improve your healing.

Some surgeons may recommend a hand splint to aid comfort and improve the position and function of your fingers. Splinting, however, is not always beneficial.

You will be encouraged to return to your activities as soon as you can.

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WebMD Medical Reference

Reviewed by David T. Derrer, MD on December 28, 2013

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