Candidates for Dupuytren's Contracture Release

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Dupuytren's contracture is a fairly common disorder of the fingers. It most often affects the ring or little finger, sometimes both. Dupuytren's contracture forms when the palmar fascia tightens, causing the fingers to bend.
The palmar fascia lies under the skin on the palm of the hands and fingers. This fascia is a thin sheet of connective tissue that covers the tendons of the palm of the hand and holds them in place. It also prevents the fingers from bending too far backward when pressure is placed against the front of the fingers. The fascia separates into thin bands of tissue at the fingers. These bands continue into the fingers where they wrap around the joints and bones.
The goal of surgery is to remove the diseased fascia, allowing the finger to straighten out again. By removing the tight cords and fascia, the tension on the finger is released. In some cases, grafting extra skin in the area close to the incision gives the finger more flexibility to straighten.

At surgery, an incision will be made in the skin. Once the palmar fascia is exposed, it will be carefully separated from nerves, arteries, and tendons. Special care is taken not to damage the nearby nerves and blood vessels.
Then your surgeon will remove enough of the palmar fascia to allow you to straighten your finger. Once the fibrous tissue is removed, the skin is sewn together with fine stitches.

Your hand will be bandaged with a well-padded dressing and a splint for support after surgery. The splint will keep the hand open and the fingers straight during healing. Your surgeon will want to check your hand within five to seven days. Stitches will be removed after 10 to 14 days, though most of your stitches will be absorbed into your body. Because many nerves are found in the hand, you may have some discomfort after surgery. You will be given pain medicine to control the discomfort.

You should keep your hand elevated above the level of your heart for several days to avoid swelling and throbbing. Keep it propped up on a stack of pillows when sleeping or sitting up.



Harris Gellman

Harris Gellman, MD

Orthopaedic Surgeon

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