Dupuytren's Disease
Surgery
Surgery is the main treatment option for severe cases of Dupuytren's disease. The goal of surgery is to restore the use of your fingers and hand. In most cases, surgery removes the diseased soft-tissue bands that connect your finger joints to the palm, and may involve a skin graft. Total hand function may not be completely restored by surgery. Even with successful surgery, thickened palm tissue may develop again in the same place or in a new area of the hands. Reoperation is often necessary to maintain hand function.
You may improve the outcome if you do post-surgical rehabilitation with finger exercises and splints, as directed by your health professional.
Surgery Choices
Depending on your condition, your surgeon will choose one of the following surgical procedures:6
- Fasciectomy. Removal of the affected tissue (fascia) is the most common procedure.
- Fasciotomy. The cords of fibre in the palm are divided through small incisions. This procedure is reserved for people who cannot have more extensive surgery or general anesthesia.
- Amputation. Removal of one or more fingers is rarely needed but may be done if earlier procedures have resulted in nerve or vessel damage or the disease has recurred repeatedly and severe contracture exists.
What To Think About
Your decision whether to have surgery should consider:
- Presence of any other health conditions or diseases, such as diabetes.
- Willingness to undergo post-surgery rehabilitation, which is necessary in order to restore hand function.
- The severity of the loss of function and how you are affected in your daily activities.
- Age. The risk of complications and treatment failure are greater with advanced age.
Needle aponeurotomy is a form of fasciotomy that is done as an outpatient procedure with local anesthesia. This procedure is available in Canada and has been done for several years in France; it is just being introduced in the United States. This procedure only partially corrects pulling or contracture between the fingers and the palm. Also there is chance of damaging nerves of the adjacent fingers and there is a high chance the contracture will come back.
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| Author: | Douglas Dana Ralph Poore | Last Updated: June 20, 2006 |
| Medical Review: | William M. Green, MD - Emergency Medicine Adam Husney, MD - Family Medicine David Pichora, MD, FRCSC - Orthopedic Surgery | |
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