DUPUYTREN'S CONTRACTURE

Fibrous thickening in hand and fingers leading to contracture of fingers

Operation

Indication: Unable to place hand/fingers flat on table

Fasciectomy and Z-plasty

Recurrence

Nerve injury - numbness, loss of sensation

Wound problems - breakdown/slow healing, infection

Bleeding, impairment of blood supply to finger(rarely, risk of finger loss)

Pain in scar/wound, swelling of fingers; chronic/severe pain(complex regional pain syndrome)

Persisting contracture/stiffness of joint(esp if longstanding Dupuytren's)

Needle Fasciotomy - dividing the bands with needle(high risk of recurrence; good esp if long hospital waiting list)

Observe