Fasciectomy
What is Dupuytren’s Contracture?
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 progresses, 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:
The procedure to correct Dupuytren’s Contracture is called a fasciectomy. This involves a zig-zag incision into the palm of the affected hand and removal of thickened connective tissue. The surgery typically lasts about 1 hour and is performed as an outpatient procedure, meaning you will be able to go home that day.
Things to know:
- You will be discharged with an Ace wrap. Following discharge please ensure that the surgical site is kept clean and dry for 48 hours.
- 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 replace the Ace wrap.
- You will be seen in our office 1-3 days after your procedure.
- 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
- It is important to elevate your arm on a couple of pillows to alleviate pain and swelling.
- Sutures will be removed in 10-14 days.
- Typically follow up appointments are scheduled in two-week intervals following surgery, so we can monitor your recovery.
Postoperative restrictions are as follows:
- No use of the affected hand.
- Keep incision site covered till sutures are removed.