Dupuytren’s contracture affects a layer of tissue that lies under the skin of your palm called the palmar fascia. Knots of tissue form under the skin, eventually forming a thick cord that can deform one or more of your fingers making it impossible to straighten those fingers. Though the changes are usually gradual, patients who have the familial variant have a more early onset, aggressive form of the disease that can involve more fingers and also other areas of the body such as the feet. A number of treatments are available to treat the progression of Dupuytrens contracture. While non-surgical methods are available, with some good early results, the mainstay of treatment is the excision of the affected tissue. Dependent on how long the disease has been present, its aggressiveness and the pre-operative state of the joints in the affected digit, surgery can return the finger to almost a full range of motion.
If the condition is early in its course or very mild, Dupuytren’s disease may be managed without surgery, although most patients progress to a point that does eventually need an operation. Non-surgical measures include: splinting, massage with Vitamin E cream, or injection into the cords and nodules.
When your hand function becomes compromised or when the contractures go beyond a manageable degree, surgical intervention is usually the best option. For most patients this means a surgical excision of the cords, release of the contractures, and occasionally a skin graft.
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The procedure is done under general anaesthetic, as a day-only procedure.
After the surgery your hand will be bandaged and placed in a splint. You will be given a sling on discharge to elevate the hand and help reduce swelling and pain. You may need to wear your splint for up to three months after the procedure. Patients will also have ongoing hand therapy to improve function and prevent recurrence.
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Dr Rohit Kumar is an Australian trained and fully certified cosmetic plastic and reconstructive surgeon.
Dr Kumar completed his Bachelor of Medicine and Bachelor of Surgery (MBBS) degree in 1995 at the University of Queensland. He subsequently went on to successfully complete a Masters Degree in the field of Burns Surgery in 2004 – MMedSci (Burns)
His advanced surgical training commenced in the specialty of General Surgery in which he trained for four years. This gave him a solid foundation of technical knowledge and surgical perspective upon which he then built his considerable skills, once he commenced his advanced training in Plastic and Reconstructive Surgery. The Australasian training scheme in Plastic and Reconstructive Surgery is one of the most thorough and rigorous in the world and upon successful completion of this training, over a period of ten years, Dr Kumar was awarded his Fellowship in Plastic and Reconstructive Surgery – FRACS (Plas).
He thus brings over 15 years of surgical experience to his practice having been involved in over ten thousand procedures in that time.
If you require surgery for Dupuytren’s disease, then it is important that you are informed of the potential risks, complications and side effects of this surgery.
While all care is taken to minimise or totally avoid these complications and side effects, complications may and do occur despite the best medical care. It is important that you carefully read and understand the risk factors and they will be discussed in more detail when you have your consultation with your surgeon.
The Risks include…
- Damage to the artery or blood supply to the digit
- Damage to the nerve to the digit
- Inability despite surgery to extend finger
- Loose or unstable joints of the finger
- Loss of digit
- Chronic pain