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What Happens to Your Hand When You Have Dupuytren’s Contracture Surgery?

Dupuytren’s Contracture is a condition that makes movements of the hand difficult. This is because the fingers will bend unnaturally towards the center of the hand and become almost fused in this position. The fingers bend in this way because of the contracture of the palmar fascia. There are no official Dupuytren’s Contracture Causes; however, certain lifestyle choices are known to trigger the symptoms. Things like excessive alcohol intake and smoking cause the disease to react. It is also passed down through genetics, especially in those who are of Nordic descent. 

 

Patients often don’t have any choice other than surgery when attempting to treat Dupuytren’s disease. Dupuytren’s Contracture Surgery is the most common form of treatment, and there are a few variations to the operation used. There are a few different surgeries that are used to treat the condition. 

 

A limited fasciectomy is the most used surgery. In this technique, the patient is put under general anesthetic.  The surgeon then makes an incision, usually zig-zag shaped in the area affected by the Dupuytren’s. Once the incision is made, the infected cords and fascia are removed. The wound in the closed with stitches or another fusion method, partial areas are left open to fuse naturally. The surgery comes with many risks, including permanent nerve damage, painful flare-ups, and painful surgery scars. The scars left are also extremely unsightly and may become infected. 

 

A dermo fasciectomy is performed the same way as a fasciectomy; the difference being rather than an open wound, a skin graft is done. This procedure has fewer complications; however, it is not 100 percent successful. 

 

Although surgery is the most common treatment, it is not necessarily the most successful. The use of the Dupuytren’s wand and Dupuytren’s tape together is proven to be extremely effective in reducing symptoms and making movements more comfortable. Also, a far less expensive and safe option compared to surgery.

 

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Complications Faced After Dupuytren’s Contracture Surgery

Getting surgery is a risk, but one that you may have to take, especially if you have Dupuytren’s contracture disease. It is possible to experience complications after Dupuytren’s contracture Surgery as the surgeons are dealing with a tissue near the nerves of your hand.

 

There is a risk of worsening the contractures, but your doctor will  provide you with details of any risks before moving forward with surgery. Some risks include:

  • Increased pain
  • Scars 
  • Damage to nerves/blood vessel
  • Possibility of infection 
  • Loss of sensation of touch 
  • Stiffness 
Recovery process

Similarly, as your doctors notify you of the risks, they may also provide you with a recovery plan. After surgery, you are likely to experience pain, stiffness, and swelling. Your doctor will most likely instruct you to hold your hand above your heart and gently flex your fingers. This helps to reduce pain and swelling after surgery, aiding you in recovery. He or she may also recommend that you use a splint to provide support to your hand, and, at the same time, prevent you from overstretching your hand. 

 

These post-surgery practices reduce further strain on your wound. This helps in healing and recovering quickly, thereby leading to better movement and flexibility in your affected hand. If you go to the doctor as soon as possible and listen to his or her recommendations, you can improve the state of your Dupuytren’s contracture.

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Surgery for Dupuytren’s Contracture

Many people consider surgery to be the only viable option for treatment for Dupuytren’s Contracture, but they often overlook the risks that accompany the surgical methods.

 

What is the Surgery Like?

There are two types of surgical methods equipped to deal with Dupuytren’s Contracture.

 

Two Surgical Procedures most commonly used:

 

Fasciotomy:

In this procedure, a cut is made into the palm, and the thickened cords of tissue causing the contracture are divided. The cord itself is not removed during the procedure. The procedure is done under local anesthesia, and the wound is left open to heal itself.   Please see this video for more details of the surgery: 

 

 

Subtotal Palmer Fasciectomy:

In this procedure, an incision is made in the palm to actually remove the thickened cords and tissue so that the finger can be straightened again. Sometimes the wound is left open to heal itself, and other times a skin graft is used to close it. This procedure requires a longer heating time.   Please see this video for more details of the surgery:

 

 

Recovering from these Surgeries:

Some pain, swelling, and stiffness in the affected area are expected after the surgeries are completed. Sometimes stiffness results in losing flexion in the fingers. 

Physical therapy is often required after the surgery as a gentle movement of the fingers decrease swelling and help ease the stiffness. A splint is to be worn after every surgery for proper heating.

 

Risks Involved:

Like any surgery, surgery for Dupuytren’s Contracture also comes with a lot of risks. 

 

Some common risks are:

  • Post-surgery pain and scarring in the affected area.
  • Open wound heating may cause wound infection.
  • Nerves or blood vessels may be injured.
  • Loss of sensation in the area.
  • Loss of finger or usage of a finger in rare cases.

A lot of people tend to avoid surgery due to the large number of complications accompanied by it.

 

End Result:

The surgery does not always provide a permanent cure as the contracture may return at any time. Recurrence is common, and additional surgery is required in some cases.

 

Many people consider surgery to be the only viable option for treatment for Dupuytren’s Contracture, but they often overlook the risks that accompany the surgical methods.

 

 

 

 

 

 

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TIPS FOR DUPUYTREN’S POST OPERATION CARE

Post-operation care after getting your Dupuytren’s contracture surgery is more important than most patients understand. From dressing and wound management to pain control, there are a number of factors that you must keep in mind to ensure a successful recovery of your hand. So, if you’ve recently gone through a Dupuytren’s contracture surgery, then the following tips will help ensure a proper care regime for our hand:

 

  • Make sure to avoid extensive use of your fingers on activities like typing, at least for 2-3 weeks after getting your hand-operated. Otherwise, chances of swelling will increase, causing you discomfort in the long run.
  • Follow a routine therapy session for about 2-3 months under the supervision of a medical professional. 
  • Avoid carrying too much weight from your operative hand, especially until it has healed completely.
  • Consult your surgeon about when you can drive again.
  • Take at least 1-2 weeks off from office to rest and ensure complete healing of your hand.
  • Use lukewarm plain or soapy water while exercising your hand, as it will make the process easy and gentler.
  • Start wearing Dupuytren’s Tape after 3-6 months of the surgery, or once your scar tissues are settled for ease and restoration of your range of motion.
  • Avoid wearing a brace if permissible by your surgeon as it typically interferes with your hand’s motion.
  • Get in touch with your doctor to work on finger flexibility training with the right exercises.

 

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RISK FACTORS ASSOCIATED WITH DUPUYTREN’S CONTRACTURE SURGERY.

With time, Dupuytren’s contracture condition is likely to worsen and cause discomfort doing the simplest of tasks. This is why many people seek Dupuytren’s contracture surgery as a measure to counter the situation. But, surgery is one Dupuytren’s contracture treatment that is not free of risks or side effects. Here are some of the most common risk factors associated with Dupuytren’s contracture surgery –

    • Scar Tissue –

One of the most common risk factors associated with Dupuytren’s contracture surgery is scar tissue. Scar tissue occurs due to an invasive surgical treatment, which sometimes ends up being more painful than the original disease.

    • Skin Damage –

Skin damage is also common with patients who undergo a surgical treatment for Dupuytren’s disease. Some surgeries call for skin graft to close the wounds, which ultimately makes the skin more tight and inflexible than before.

    • Nerve Injury –

Another complication that can occur during a Dupuytren’s contracture surgery is a nerve injury. As Dupuytren’s cords are sometimes enveloped around nerves in the hand, an invasive surgical treatment can easily cause an injury to the nerve and cause serious issues for the patient.

If you have started to notice the symptoms of Dupuytren’s contracture in your fingers, then wearing Dupuytren’s Tape can offer an easy and consistent solution to help restore your hand’s normal function. The best part about using Dupuytren’s Tape is the fact that it not only promotes your normal grip butcan also be worn all day and all night long!