hand - dupuytren’s disease
Introduction
Dupuytren’s disease is an abnormal thickening of the fascia (the tissue just beneath the skin of the palm). It often starts with firm lumps in the palm. In some patients, firm cords will develop beneath the skin, stretching from the palm into the fingers. Gradually, these cords may cause the fingers to bend into the palm. Although the skin may become involved in the process, the deeper structures—such as the tendons—are not directly involved.
The cause of Dupuytren’s disease is unknown but may be associated with certain biochemical factors within the involved fascia. The problem is more common in men over age 40 and in people of northern European descent. There is no proven evidence that hand injuries or specific occupational exposures lead to a higher risk of developing Dupuytren’s disease.
The surgery
In some cases, only observation is needed for nodules and cords that are not contracted. Patients with more advanced contractures may require surgery in order to improve function.
Surgery for Dupuytren’s Disease is performed in hospital under general or regional anaesthesia.
Various surgical techniques are available in order to correct finger position. Mr. Bloom will discuss the method most appropriate for your condition based upon the stage of the disease and the joints involved. The goal of surgery is to improve finger position and thereby hand function.
As with any surgery, although uncommon there are risks. These include infection, haematoma, slow wound healing, stiffness, nerve injury and swelling. Despite surgery, the disease process may recur and the fingers may begin to bend into the palm once again.
After your Surgery
In most situations you will able to go home on the day of your surgery, however the length of your hospital stay will depend on your general health, the extent of the procedure, and your surgeon's advice.
At the time of discharge your hand will be in a splint and covered in a bandage. Within the first week following the operation, an appointment will be made for you to see a hand therapist who will start mobilising the fingers and remove the splint. A new splint will be made for you at that time, which is to be worn at night for up to 6 months.
Returning to normal activities is an individual matter, but most people return to work within two to four weeks and to more vigorous activities after six weeks.