The procedure | Dupuytren’s contracture release

In Dupuytren’s disease, named after the French Baron Dupuytren, a collagen contracture inside the hand causes progressive bending of one or more fingers. The surgery consists of removing this contracted tissue. Recent developments have resulted in the introduction of medication that can dissolve this particular tissue when injected under the skin.

Where will I be operated?

If the treatment will be by injection, then this will be done at the time of consultation. If an operation is the best option in your case, then this will be performed in the fully equipped operating theatre at the Radetzky villa.

What can I expect of the operation?

The operation will be performed under regional anaesthetic and will take approximately 30 to 60 minutes. Your surgeon will always see you before the operation and will talk you through the steps. The procedure will start with numbing the nerves in your arm, followed by prepping and draping of your lower arm and hand. Markings will be made on your fingers and your arm will be elevated in order to reduce the amount of blood inside. Then a band around your upper arm will inflate tightly to prevent blood from running through your arm for the period of the operation. Your surgeon will use a precise electric devise to stop any bleeding that may occur and will use a suture to close the wound.

What are the risks?

Dupuytren’s contracture release is considered to be a low risk procedure. The most common complications are postoperative bleeding, infection, or scar reactions. In some cases this may lead to prolonged recovery. Support by hand therapy is important.

What can I expect after the operation?

Your hand will be bandaged for 24 hours, during which time regular elevation – with your hand being higher than the elbow – is wise. When the anaesthetic wears off you may experience some slight discomfort. In the first few days healing will include some swelling and (variably) some restricted movements. These should however gradually disappear, as you are encouraged to use your hand as normal as possible. The sutures will be removed after 1 to 2 weeks. Hand therapy will be important in the first few weeks of your recovery.

What will the scars be like?

The scar will run like a zig-zag on the inside of the hand and affected fingers. It will be slightly red for the first few months. Eventually the colour will even out. Typically a scar will take one year to fully mature and in the majority of cases the scar, although present, should not be on the foreground anymore by that time.

How long before I can resume my normal life?

Most people manage to return to light activities in the first few days after surgery. At one to two weeks after surgery a follow-up appointment will be made for you at the Radetzky villa, where the sutures will be removed. From then on you are allowed to do everything again. However, please listen to your body though; pain is a protective mechanism, so if certain movements are painful please do not overdo them.

What is good to know about the long term?

Dupuytren’s disease is a progressive disease. In some cases it reoccurs, which may necessitate further treatment.
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