Hi

I am 57. My employment is principally office based and involves some driving. No one in my family that I know of has had Dupuytren's Disease. I am not diabetic. I am right handed. Recent surgery appears to have stimulated the disease process.

Before surgery the little finger of my left hand was contracted by 90o at the proximal interphalangeal (PIP) joint to the extent that if my palm was face up and my hand was horizontal my little finger beyond the PIP was vertical, also there was obvious thickening of the fascia in my left palm. No other fingers were affected on my left hand. Despite some thickening of the fascia on my right hand no fingers are contracted. The progress of the disease had been coming on for several years. In August 2008 my GP agreed that I should be referred to a consultant at my local hospital and I was admitted as a day patient for surgery on 7th Oct 2008.
Following surgery my hand was bandaged to enable the zigzag shaped wound to heal and I had to wear a splint 24 hrs a day for 4 weeks, on my forearm and the back of my wrist and hand, to keep little finger extended.
I have been advised to wear the splint every night since the operation. I am due to have a review of my condition in mid February 2009.

Problems following Surgery:-
1. The first thing that happened was that the stitches split along the wound along the crease at the base of the little finger where it joins the palm. I was informed that an open wound here was normal and that in the past following surgery this wound would not have been stitched anyway to avoid scar tissue type contractures.
2. My hand swelled after surgery around the left little finger and the finger next to it which are about half again as thick as the same fingers on my right hand. Also the back of my hand is swollen over the knuckles and the PIP joints of the same fingers.
3. There is thickening in my palm below these two fingers which may be scar tissue but a course of ultra sound treatment and frequent and regular manipulation of this area and the swollen fingers using an aqueous cream has done nothing to relieve the situation.
4. My left wrist has become swollen and stiff and is very painful if I try to flex it or extend it in a similar manner to my right wrist. I have tried lots of exercises and heat pads around my swollen wrist and fingers with no relief of the swelling or pain.
5. My left little finger has never gone completely straight and is now contracted towards the palm in a flexed position of 45o to the horizontal at the PIP joint.
6. The finger next to my left little finger is also now contracted towards the palm in a flexed position about 35o to the horizontal, and the central finger next to that although almost straight has some thickening below the PIP joint and is painful if I try to force into full extension.

Any advice concerning what to do about this situation particularly from those who have suffered the same fate would be gratefully appreciated.

Regards

Rich

I had a similar situation and had wonderful success following day surgery on my dominate hand.

I was diligent at the stretching excercises and physical therapy and rubbing out the scar tissue. In every meeting, I would stretch and rub the scar tissue.

I am less than a year from surgery, but it looks good and has nearly perfect flexiblity. My wife and kids have been amazed at the improvement.

I credit the physical therapy and my time dedicated to doing it multiple times every day.

Stretch.
Flex.
Massage the scar tissue, often.

I had surgery on 15/12/2008.



This is one week later.

This is four weeks later.


Not bad eh?

Not bad if it's a one off.

Cambidgeshire, UK.

Hi Folks

Thanks for your replies. Unfortunately my operation and aftercare doesn't seem to have gone so well.

From the day of the operation onwards both the the little finger and the finger next to it were very swollen and have remained so. Following attendance for 4 weeks at the dressing clinic whilst the wound healed, I was told to exercise my hand by flexing and extending it throughout the day and to wear the splint at night and to rub aqueous cream over the area where scar tissue existed. All of which I did on a regular basis many times a day. this did nothing to reduce the swelling. I was also asked by the staff at the dressing clinic whether I would like to have physiotherapy following discharge from the dressing clinic (about a month after the operation).
What followed was about 5 appointments with a physiotherapists for ultrasound. This course of treatment did nothing to reduce the swelling in my fingers and just before Christmas 08 the physio phoned the hospital where I had been for the operation to request that I be seen by the consultant for a review of my condition as it appeared to be getting worse as I could not straighten my little finger and the finger next to it and even the index finger were contracting.
Several weeks went by without an appointment from the hospital to see the consultant so I went to see my GP, who immediately wrote to the consultant with the result that I had an outpatient appointment on 13 Feb 09. this was the first time I had seen a consultant (actually his senior house officer or registrar) since the operation 4 months ago at the beginning of Oct 08. This person asked me how I was progressing with Physio to which my reply was "what physio". He said I should have had "aggressive" physio straight after my hand had healed prior to Christmas.
He has now referred me for outpatient physio at the hospital where I had the operation for intensive physio. I am not sure what this will be and how the therapist is going to be able to straighten my little finger which is again as it was pre. op at an angle of 90o at the pip joint, and the finger next to it which was straight pre op is now at at 45o at the pip joint and 45o at the dip joint.
I also still have great difficulty in fully flexing my fingers and can't bring my fingertips to my palm. The Register or senior house officer was talking about splinting on the palm as well as splinting on the back of my hand to correct these problems which he assured me were due to scar tissue and not a reoccurrance of the Dupuytrens disease, although he did think that it may be reoccurring to a degree in my middle finger.

You can imagine I am not happy with the post operative care I have received so far, particularly when I read how well some of you have recovered.

I would appreciate any comments particularly form those whose initial after care and outcome of the operation didn't go so well. What intensive physio worked for you?

Regards

Richard