Dupuytren's fasciectomy at Oxford, The Manor Hospital
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Dupuytren’s disease occurs when 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 permanently curl up into the palm.
This condition is known as Dupuytren’s contracture.
If your Dupuytren’s is not painful or causing you mobility problems you may not need any treatment. You should discuss your symptoms with your GP before seeking any treatment.
If your symptoms are painful or you are having problems performing daily activities due to your Dupuytren’s there are several treatments available:
- Radiation - Several doses of radiotherapy sometimes slows or halts the symptoms
of Dupuytren’s. The side effects of radiation can include dry skin, skin flaking off or thinning of the skin.
- Needle Aponeurotomy - sometimes called a needle fasciotomy, this outpatient procedure involves severing the fibrous tissue in your hand using a very fine blade or needle. You will be given a local anaesthetic so your hand will be completely numb. Most patients experience an immediate reduction in symptoms however the incidence of a return of symptoms after this procedure is very high. In many cases the procedure may need to be repeated.
- Collagenase Clostridium Histolyticum injection - Collagenase is a fairly new drug that can be injected into the bands of tissue. This drug actually reacts with the fibrous collagen in your hand to break up the tissue. Twenty four hours following your injection you will visit your consultant who will straighten and stretch your bent finger(s). If unsuccessful the injection can be repeated up to three times. The side effects of collagenase injections can include swelling, bruising, bleeding and pain.
- Surgical correction (Fasciectomy) - if your fingers can not be straightened using any other treatments your consultant may recommend surgery.
What happens during Dupuytren’s fasciectomy surgery?
Surgery for Dupuytren’s can be done under local, regional or general anaesthetic. The operation can range from simply cutting the fibrous band in the palm of your hand removing all of the affected skin and replacing it with skin grafts. After your operation your surgeon will close any incisions with stitches and apply a dressing.
Going home after Dupuytren’s fasciectomy surgery
You should be able to go home on the day of your surgery. Your hand may be sore and swollen but this should settle within the first few weeks of your recovery.
Although surgery can improve the flexibility of your fingers it does not cure Dupuytren’s disease. If your symptom occur again you may need a second operation.
What are the complications of Dupuytren’s fasciectomy surgery?
Any surgical procedure may result in complications. These could include:
- Infection of the surgical site (wound)
Specific complications of Dupuytren’s fasciectomy may include:
Injury to an artery in the finger
- Incomplete correction of the contracture
- Return of the symptoms
- Stiffness of the finger joints
- Wound healing problems
- Severe pain, stiffness and loss of use of the hand (complex regional pain syndrome)
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