Dupuytren’s Contracture Surgery

What is Dupuytren’s contracture?

Dupuytren’s contracture is a condition where the connective tissue (fascia) beneath the skin of your palm thickens and tightens over time. This can cause one or more of your fingers to bend towards your palm, making it difficult to straighten them. The condition can affect daily tasks such as gripping objects, writing, or shaking hands. It is more common in men, people over 40, and those with a family history of the condition.

When is surgery needed for Dupuytren’s contracture?

Surgery is recommended when the contracture significantly affects the function of your hand or limits your ability to perform daily activities. Common signs that surgery may be needed include:

• Difficulty straightening your fingers
• Problems gripping or holding objects
• The condition worsening despite non-surgical treatments

Surgery aims to release or remove the thickened tissue, allowing you to straighten your fingers and regain hand function.

What types of surgery are available?

Several surgical options are available for Dupuytren’s contracture, depending on the severity of your condition. Your surgeon will recommend the best approach for you:

• Fasciotomy: A minimally invasive procedure where the surgeon cuts the thickened cords of tissue causing the contracture. This helps release the fingers and improve movement
• Fasciectomy: In this more extensive procedure, the surgeon removes the affected tissue entirely. It is often recommended for more advanced cases and provides longer-lasting results
• Dermofasciectomy: This involves removing both the affected tissue and the overlying skin. A skin graft is used to cover the area and is often recommended for severe or recurrent cases

What happens during Dupuytren’s surgery?

The surgery is usually performed under local or regional anaesthesia, so you will be awake but won’t feel pain in your hand. In some cases, general anaesthesia may be used.

During the procedure:

• The surgeon makes small incisions in your palm and fingers
• Depending on the type of surgery, the thickened cords of tissue are cut or removed
• If needed, a skin graft is placed to cover the area
• The incisions are then closed with stitches, and a dressing is applied

The surgery typically takes between 30 minutes and 2 hours, depending on the complexity of the case.

Benefits of Dupuytren’s release surgery

Surgery can significantly improve your quality of life by:

• Restoring the movement of your fingers
• Reducing discomfort caused by the contracture
• Making it easier to perform daily tasks and use your hand

Most people experience a noticeable improvement in hand function after the procedure.

Risks of Dupuytren’s release surgery

As with any surgery, there are potential risks, including:

• Infection or bleeding.
• Stiffness or reduced sensation in your hand.
• Scarring or delayed wound healing.
• Recurrence of the contracture over time.

Your surgeon will explain these risks and take steps to minimise them during and after the surgery.

Recovery and aftercare

Recovery times vary depending on the type of surgery and your overall health. Following these steps will help you heal faster and regain hand function:

• First 1–2 weeks: Keep your hand elevated and apply ice packs to reduce swelling, and avoid heavy lifting. Follow wound care instructions to prevent infection
• Weeks 2–6: Start gentle hand exercises, attend therapy sessions if advised, and avoid excessive strain on your hand. Maintain a healthy diet to support healing
• After 6 weeks: Gradually regain strength with exercises, modify daily activities to avoid overuse, and attend follow-up appointments to monitor progress

With the right care, most people achieve significant improvement in hand function and quality of life. If you experience persistent pain, stiffness, or signs of recurrence, consult your surgeon for further guidance.