Dupuytren’s Contracture

Dupuytren’s Contracture

Dupuytren’s is a condition thought to originate from Viking ancestors whereby a type of scar tissue forms in the palm and in the fingers causing the fingers to contract and curl round into the palm.

Fasciectomy

This operation is regarded as the standard procedure for Dupuytrens contracture when the condition is sufficiently advanced to interfere with function. The operation is designed to remove as much of the abnormal dupuytrens tissue as possible and to correct the contracture of the fingers. Following the operation patients require quite a lot of hand therapy and it can take some weeks or even months to get the full benefit of surgery. The recurrence risk is probably less after a fasciectomy than the minimally invasive techniques of needle fasciotomy.

Pictures re dupuytrens-tissue (4)

Surgery is indicated when the fingers are interfering with function or the disease is progressing quite rapidly. Different techniques are available to treat the condition. Surgery is aimed at correcting the deformity of the hand and removing the Dupuytren’s tissue. It is not always successful at straightening the fingers completely.

Needle Fasciotomy

This technique is used as a minimally invasive procedure for Dupuytren’s contracture of the hand. It is done under a local anaesthetic and involves breaking up the Dupuytren’s tissue with a hypodermic needle and a manipulation to try and correct the deformity. There are usually no stitches but the wounds are just covered with a plaster and patients are usually free to mobilise the hand straight away.

This technique breaks up the Dupuytren’s tissue but does not remove the Dupuytren’s tissue itself. Therefore, there is a risk of recurrence of a contracture. However, the recovery following this procedure is a lot quicker than having a fasciectomy which involves a much bigger scar and wound.

pictures dupuytrens needle fasciotomy 1 to 7 (7)

Recurrence of the dupuytren’s contracture can occur after any treatment for dupuytrens.