Procedure-specific guides
Dupuytren’s fasciectomy
To be read alongside the care pathway pages. Therapy plays a particularly important role here.
The operation
The diseased cord is removed through a zigzag incision that follows the natural creases of the palm and finger. That line is not for appearance: a straight scar crossing a crease would tighten and bring the problem back.
The operation takes longer than a carpal tunnel release, because the nerve and artery of the finger are wound around the cord and have to be freed one by one.
- A skin graft is sometimes needed in aggressive disease.
- The finger may not straighten fully if the middle joint has been contracted for a long time.
- Temporary numbness of the finger after the operation is common.
Splinting and therapy
Therapy starts early and is half the treatment. A custom splint is made and worn at night for several months, to hold the correction gained in the operating room.
Scar tissue naturally tightens over the first months: that is what the splint and the exercises are working against.
- Wear the night splint for as long as you are told, even if the finger looks straight.
- Do the straightening exercises several times a day.
- Massage the scar once the wound is closed to soften it.
Longer term
This should be said plainly: Dupuytren’s is a condition, not an isolated event. Surgery removes the cord that is there today; it does not remove the tendency to form another.
Recurrence over the years happens in a proportion of patients, more often when the disease started young or affects several fingers. That is not a failure of the operation, and further surgery remains possible.
- Report any new cord or loss of straightening at your follow-up.
- The hand regains suppleness over several months, not a few weeks.
- Return to manual work: to be discussed, depending on the finger and the extent of surgery.
Urgent
When to call, and who to call
Fingers that are cold, white or bluish, loss of sensation, severe and increasing pain that painkillers do not touch, a dressing that has become too tight, or bleeding that does not stop after ten minutes of pressure: go to the emergency department without waiting for a call back. For a fever, spreading redness or discharge, call the office the same day. If you are unsure, call 811.
Information on this site is general and does not replace a medical consultation. In an emergency, call 911.