DUPUYTREN'S CONTRACTURE

Fibrous thickening in hand and fingers leading to contracture of fingers

Operation - Fasciectomy and Z-plasty

Indication for surgery: Once one is unable to place the affected fingers flat on table

Surgery - this is preferably performed under general anaesthesia; takes on average about 30-45min

Postop - the hand will be in a bandage, elevate the hand in a sling when not using it, remove bandage after 1-2 weeks. Stitches used are usually dissovable - will come off 1-2 weeks after the bandage is removed

Risks

Recurrence

Nerve injury - numbness, loss of sensation(from damage to digital nerve - especially if there is a spiral band of Dupuytren's curling around nerve or in recurrent cases)

Wound problems - breakdown/slow healing, infection(report to doctor immediately if there is increasing pain or smell in wound)

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) - Not being able to fully correct the contracture with the surery

Other Options for treating Dupuytren's contracture 

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

Observe - for early Dupuyren's where there is not yet any fixed flexion deformity

Hand Surgery - Melbourne Surgery