Dupuytren’s contracture surgery

What is Dupuytren’s contracture?

Dupuytren’s contracture is a connective tissue disorder characterized by excessive growth of the subcutaneous tissue of the hand, known as the fascia. Nodules and bands formed from this tissue appear on the palm (and eventually on the fingers), causing finger contractures, meaning the inability to fully straighten them. Typically, the contracture affects the fourth and fifth (smallest) finger of one hand. The disease most often affects men over 40 years old, is painless, and progresses slowly. In advanced stages, it impairs hand function, especially gripping, leading to significant limitation of finger and hand mobility.

Causes of Dupuytren’s contracture

The causes of Dupuytren’s disease are not fully known, but factors that may contribute include:

• genetic predisposition (in about 60% of cases),
• contracture development concurrent with ulnar nerve diseases,
• repeated injuries and overloads of soft tissues related to occupational work.

The disease is more frequently observed in people with diabetes and epilepsy, as well as those addicted to alcohol and cigarettes.

Surgical treatment

Treatment of Dupuytren’s contracture involves a highly specialized surgical procedure to remove pathological changes. A procedure performed by an experienced physician can fully restore the affected hand’s function. The patient requires appropriate preparation for the surgery, including a detailed medical interview, laboratory tests, and determination of any contraindications to the procedure.
The surgery consists of surgically excising or cutting the overgrown bands causing finger contractures, allowing correction of the contracture. The procedure is performed under local or regional anesthesia with ischemia of the operated limb (a tourniquet is applied). Intravenous sedation may also be administered.
After surgery, the patient remains in the clinic under nurse care for several hours and then may return home.
In the first days after the procedure, patients may experience numbness and finger pain, which can be alleviated with doctor-prescribed painkillers. To avoid stiffness and swelling of the hand and fingers, gentle finger movement, elbow and shoulder exercises are recommended for several days, as well as avoiding lowering the hand both day and night. Sutures are removed 10–14 days after surgery, and the final surgical outcome can be achieved 6–8 weeks post-procedure.

Minimally invasive surgical treatment of Dupuytren’s contracture at Wilmed Clinic

Needle fasciotomy is the least invasive surgical method for treating Dupuytren’s contracture. This procedure is usually performed under local or short intravenous anesthesia. A needle is inserted into the tissue of the hand or fingers to separate the thickened bands. The needle is moved back and forth like a saw several times. The goal is to break the band to allow finger extension.
Needle fasciotomy generally improves and reduces the severity of the contracture. However, there is a possibility (as with other treatment methods) that the contracture may recur, depending on the disease severity before the procedure. In case of recurrence, the procedure can be repeated.

Ask our specialists in modern Dupuytren’s contracture surgeries about treatment methods for your condition. We invite you to orthopedic consultations at the WILMED Clinic in Warsaw.