Dupuytren's surgery (partial or total fasciectomy)

Surgery is the most common treatment of Dupuytren's contracture. Surgery is usually considered 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 finger is already bent inwards, surgery is the only proven therapy that we know of that can make your hand straight again.

Fasciectomy of Dupuytren's contracture (Dupuytrens), before and after.

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 for stage 4 of Dupuytren's contracture (Dupuytrens).

Although radiotherapy may sometimes help 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 radiotherapy 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, 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.

Palm three years after hand surgery of Dupuytren's contracture.  Straight finger, little scarring.

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

finger is straight,very little scarring. The original nodule had been below the MCP (base) joint of the ring finger, the cord extended up to the PIP (middle) joint.


Operated hand after removal of Dupuytren's contracture, original cuts indicated.

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

(pictures provided by W. Wach, Int. Dupuytren Society)

 

For potential side effects of surgery and information on rehab please refer to surgery_side_effects.

 


Page last modified: 06/09/2012


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