Dupuytren’s fasciectomy is hand surgery that aims to straighten permanently curled fingers and improve hand function. It is performed to treat advanced Dupuytren’s disease, known as Dupuytren’s contracture.
Ramsay Health Care works in partnership with hand surgeons who have expertise and a wealth of experience in treating Dupuytren’s disease. At each of our hospitals the surgeons are supported by a team of trained physiotherapists who can offer advice and a variety of treatment options along your care pathway. So, you can rest assured you’ll receive the best of care at your local Ramsay hospital.
Dupuytren's disease is a hand deformity that develops over years. It causes the fibrous layer of connective tissue that lies just underneath the skin in your palm and fingers, called fascia, to thicken and tighten.
As the fascia develop into thick cords and contract over time, your fingers can be pulled in towards your palm, known as a Dupuytren's contracture, making it difficult to straighten the affected digits.
To a lay person, Dupuytren's disease is sometimes confused with trigger finger, a condition that can also result in bent fingers, but is an entirely different process and as such requires a different surgery, called trigger finger surgery.
Dupuytren’s surgery can help straighten fingers and improve hand function, affected by Dupuytren’s contracture.
Dupuytren's contracture surgery divides or removes the thickened tissue in your palm and digits with the aim to treat Dupuytren’s disease.
The operation can be performed using different methods depending on your needs. Your hand surgeon will discuss your treatment options with you.
Surgical options include:
Open or needle fasciotomy – usually an outpatient procedure performed under local anaesthetic. A sharp blade or a very fine needle is inserted into the fibrous bands of your palm or fingers to divide the thickened connective tissue and release the tightness in your hand that is causing the contracture. The recurrence rate for needle fasciotomy is high.
Dupuytren’s fasciectomy – usually performed under general anaesthetic as an outpatient procedure. An incision is made in your hand and the affected connective tissue is removed. A skin graft may be required to seal your wound. Fasciectomy is used to treat more severe cases. It is more effective than fasciotomy in the long term but carries more risks.
The main types of fasciectomy include: segmental (short segments of the cord are removed through one or more small incisions), regional (entire cord is removed through a single longer incision) and, dermo fasciectomy (cord and overlying skin is removed requiring a skin graft).
When Dupuytren's contracture becomes moderate or severe, Dupuytren’s surgery may be recommended to reduce the contracture and improve motion in the affected fingers. Dupuytren’s surgery is likely to be helpful if it has become impossible to put your hand flat on a table.
If you decide to pay for your treatment, Ramsay offer an all-inclusive Total Care package, where a single one-off payment at a pre-agreed price, delivering direct access to all the treatment you need for complete reassurance. You can also spread the cost of your treatment with finance options available.
A dupuytren's fasciectomy surgery may be covered by your medical insurance policy. We advise you to check directly with your insurance provider and get written confirmation before commencing treatment.
Typically, you’ll go home the same day as your Dupuytren’s surgery, although sometimes a one-night stay is recommended.
To recover well and to minimise scar tissue you may need specialised hand therapy to help improve the function and range of movement of your hand such as physiotherapy including massage, manipulation and exercise. You may also be required to wear a hand splint initially.
It can take some time to recover the function of your hand after Dupuytren’s surgery. If you have had more extensive surgery, such as a fasciectomy rather than a fasciotomy, your recovery will be longer.
You can drive again once you feel confident to control the car safely.
There is a chance the condition will return in the same place as before or somewhere else. Surgery doesn't stop the process that caused the contracture to develop in the first place.
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Abby Marsh, Administrative Assistant at West Midlands Hospital recently completed her MSc in Public Health and Health Promotion with Merit at Swansea University.