Dupuytren’s contracture is a very slow process, often starting with a tender nodule or callus-looking thickening in the palm of the hand that may cause the finger to bend. Dupuytren’s contracture release is surgical intervention that includes needle aponeurotomy and direct regional palmar fasciectomy.
The cause of Dupuytren’s contracture is not clear but it is most common in males over 50 of Nordic decent. It most frequently affects the small and ring fingers but can also affect other fingers. Conservative treatment includes progressive splinting to try and stretch the cord, steroid injection and enzyme injection. Surgery is only offered if you are unable to place your palm flat on the table and you are having difficulties using your hand in your day-to-day life.
Dupuytren’s needle fasciotomy is done under local freezing while you are awake and takes about 30 minutes. You will be put in a temporary splint after surgery and will be given information at the first office visit to arrange a follow-up with a hand therapist a few days after the surgery. You can eat and drink before the surgery.
You will need someone to drive you home from the hospital. You can shower 48 hours after surgery. Wound care is simply washing then applying ointment and a light dressing every one or two days, along with a splint as needed. Dr. MacDonald will see you 10-14 days after surgery to ensure you are healing well.
Time off work varies and depends on whether you need to wear the splint during the day for a few weeks and how this impacts on your ability to do your job. You can use your hand immediately following surgery, other than with heavy lifting, which you should avoid for approximately 2 weeks.
As in any surgery, risks include infection, scarring, delayed wound healing, nerve or tendon injury, bruising or bleeding, and incomplete release or recurrence. Complications in this procedure are relatively uncommon but will be discussed further at the time of consultation. The severity of your contracture will often determine how much relief you will get from the surgery.