Dupuytren's Contracture

Dupuytren's Contracture is a deformity of a finger, or multiple fingers, which usually occurs over many years. It is an inherited connective tissue disorder that affects the palmar fascia in the hand, resulting in a 'knot' that forms under the skin of the palm and eventually creates a thick cordlike deformity, which can pull one or more fingers into a stiff, bent position. This condition is also known as Viking Disease, because it originated with the Vikings who spread it throughout Northern Europe, and beyond, as they traveled and intermarried; therefore is more common in people with ancestors from Northern Europe. 

The most common symptoms of Dupuytren's Contracture include firm lump that develops in palm and into one or more fingers. The lump is typically not painful, but may prevent placing the hand flat on a surface. As the condition progress, the finger(s) stiffen and become more bent making it difficult to wash hands, wear gloves, or get hands into pockets. There is no set time frame of how this condition will progress, some patients will quickly develop severe bent finger(s) and other patients may never. The most commonly involved finger is the ring finger. 

Surgery to correct Dupuytren's Contracture is called a fasciectomy.  This involves a zig-zag incision into the palm of affected hand and removal of thickened connective tissue. This is performed as an outpatient procedure, meaning you will be able to go home that day. You will be discharged with an Ace wrap. Following discharge please ensure that the surgical site is kept clean and dry until follow up appointment, typically 1-2 days post op. After 48 hours you may remove the bandage and shower. While showering, you may use soap and water, but be sure to pat the incision dry. It is important that you do not submerge your surgical incision in water (i.e. no bath tubs, swimming pools, washing dishes, etc.). After patting dry, you can redress with gauze and Ace Wrap. It is important to elevate your arm on a couple of pillows to alleviate pain and swelling.

At your first follow up appointment, you will be given a prescription for Occupational Therapy. It is important to immediately start ROM (range of motion) exercises to help prevent stiffening of affected finger(s) and thickening of remaining connective tissue. 

Sutures will be removed 10-14 days after surgery. After suture removal, you will have scheduled follow up appointments about every 2 weeks to evaluate your recovery. You will continue your specific occupational therapy protocol during this time. During this time, no lifting anything heavier than ½ gallon of milk for 1-2 months. You may begin scar massage once sutures are removed.

You may resume your regular diet after surgery; however, you should start slow. It is a good idea to start with things like toast, Jell-O, crackers, and soup to see how your stomach tolerates food after anesthesia. Drink plenty of fluids such as water or Gatorade and limit your intake of sodas, coffee and other caffeinated beverages.  

We will send you home with a prescription for an antibiotic and a pain medication. It is important to take your antibiotic and pain medication with food to prevent nausea (unless you are instructed otherwise). Do not take your pain medication and antibiotic at the same time as this may upset your stomach; separate them by an hour or two. You cannot drive while taking pain medication.

Should you develop any of the following signs and or symptoms of possible infection, call our office immediately:

  1. Fever over 100.3
  2. Chills or night sweats
  3. Unusual swelling, redness, or warmth to your incision site
  4. Purulent drainage from incision site.

Please do not hesitate to call our office with any concerns or questions you may have.

Please remember the above instructions are only a guide. Always listen to the instructions given by your healthcare provider and follow those if in conflict with any listed above

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