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Surgery of Dupuytren's contracture

It is a disease with palpable subcutaneous nodules or streaks in the palm of the affected hand. This thickening can extend to the fingers and limit their movements, especially their stretching. They are usually painless, but they may hurt and limit work. Dupuytren's contracture primarily occurs in the hands, but exceptionally also in the soles of the feet. The treatment is mostly surgical.

Indication or who the procedure is intended for

If you want to know if the procedure is suitable for you, you can perform a simple so-called "table top test". If you have this condition, try placing the affected palm on the table top. If you are able to press your whole palm against the table, you still have time. However, if your permanently bent fingers prevent your palm from pressing the entire surface against the table, it is most likely a good time for surgery.

Procedure course

The procedure is performed under local or conduction anaesthesia, exceptionally under general anaesthesia. The anaesthetic agent is injected directly into the surgical site, or into the wrist or higher on the upper limb (conduction anaesthesia). This procedure is often performed with a tourniquet on the upper limb to prevent bleeding during the procedure. The altered tissue of the aponeurosis (palpable nodules and streaks) is then removed from various incisions in the palm or fingers, while sparing important structures (vessels, nerves and tendons). In some cases, interventions in articular capsules of chronically bent finger joints are still necessary in order to straighten them. The wounds are then sutured. If skin cover is not sufficient, if it is not possible to perform a local lobe transfer. It is sometimes necessary to use a skin transplant from another place on the body. Sometimes surgical wounds are left partially unsutured.

Postoperative course

After the procedure, the operated limb should be in an elevated position, which relieves pain and reduces swelling. The sutures are removed approximately 2 weeks after the procedure, the convalescence period is approximately 4-8 weeks depending on the extent of the disability.

Physiotherapy is an important part of postoperative treatment.

However, it is never possible to remove all the tissue from the palm, which could lead to repeated development of the contracture again in the future. Thus, there is always a certain risk of progression or recurrence.

Form of payment

The procedure is fully covered by health insurance. This surgical procedure is performed in our sanatorium by all plastic surgeons.

 

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