Dupuytren's Contracture (Needle Fasciotomy and Fasciectomy)

What does this involve?

There are two options which will be explained to you by your surgeon.  In some cases a less invasive Needle Fasciotomy may be possible where a needle is passed through the skin of the palm - more commonly open surgery called a Fasciectomy is required.  Additionally we also offer Collagenase Injection as a treatment option at CircleBath, Circle Clinic Stratford and Circle Clinic Windsor.

The surgery can usually be done as a day case under local anaesthetic. Once the anaesthetic has taken effect, a tourniquet is put around the upper arm to control bleeding during the operation. Incisions are made into the affected fingers and palm. The affected tissue is removed, and the fingers are allowed to relax into their normal position.  Part of the incision is commonly left open in a crease in the palm; this allows freer movement and avoids painful collection of blood under the skin of the palm. It heals as well as if it had been stitched over a period of some four weeks.

The operation may take an hour or more, depending on how many fingers are involved.

When will I recover?

After the operation your hand is rested in a splint and bandage and elevation in a sling at all times reduces swelling.   You should be able to go home the same day and the healing wound does require regular dressing changes in the two weeks after operation. Within this time a smaller splint is fitted and your hand is mobilized. The splint should be worn at night for up to six months.

The scar may be tender for a couple of months and the surrounding skin may become very dry which can be relieved by the use of a moisturiser.

What risks should I know about?

This procedure is a commonly performed and generally safe operation. However, all surgery carries an element of risk.  Although surgery can help to improve the flexibility in your fingers, it does not stop the process of Dupuytren's disease. So the contracture may return, requiring another operation.

Some possible complications are below although you should ask your surgeon how they may apply to you: 

• In a few people the hand becomes stiff and painful. This is usually treated with physiotherapy.
• In severe cases, it may not be possible to fully straighten the fingers. Splints may be used afterwards to improve the results.
• The nerves to the fingers may be damaged, causing numbness in part of the finger. This is more likely to happen when a repeat fasciectomy is done. It may be possible to repair the damage with further surgery.

Circle care

Hand and wrist surgery is carried out by our specialist Surgeons who have the expertise to get the best possible results.  You can be sure of state of the art facilities and the best possible care to get you back to normal as soon as possible.