Dupuytren Surgery (partial or total fasciectomy)

 

Surgery is the most common treatment of Dupuytren's disease. Surgery is usually considered at a relatively late stage of the disease, typically when fingers are already bent by more than 15 to 20 degrees and the use of the hand has become restricted. In a very progressed stage, when the hand is already bent inwards, surgery is the only proven therapy that we know of that can make your hand straight again.

Classical hand surgery (fasciectomy) of Dupuytren's contracture: example on a stage 1 pinkie. Above: finger before surgery with incisions indicated. Below: straight finger, immediately after surgery. Total fasciectomy completely removes the diseased tissue aiming to avoid recurrence of Dupuytrens.

(pictures provided by Keith Denkler)

Needle aponevrotomy (NA) is an alternative to surgery and is typically applied in an earlier stage or before surgery. Recently NA is also being tried in progressed stages, even stage 4 of Dupuytren's contracture (Dupuytrens).

Although radiotherapy may still help to some extent even in late stages, the probability that it will cure for the long term is much higher in the initial stage of Dupuytren's, and it cannot get a bent hand straight again.

 

Positive results of surgery

If the operation is well performed and no complications arise, the formerly bent fingers can typically be straightened again, and the hand becomes functional again. This is a tremendous improvement in cases where the patients already had a claw like hand, and now can use their hand again. Yet before undergoing an operation, you should be aware of possible side effects. We encourage you to discuss those with your doctor and consider them thoroughly before undergoing surgery.

Well healed hand about 3 years after surgery of Dupuytren's contracture (20 deg),

finger is straight, little scarring. The original nodule had been below the MCP of the ring finger, the cord extended up to the PIP.

Above hand with original cuts indicated. A part of the palmar aponeurosis has been removed.

(pictures provided by W. Wach, Dupuytren Society)

Page last modified: 01/29/2008