How can it help?
The disease often proceeds to cause contractures in the small joints of the fingers, leading to a loss of movement in the finger. It commonly occurs in the ring finger and little finger, and occasionally the middle finger. The thumb and index finger can also be affected.
If the condition is not affecting the mobility of the hand, treatment can be delayed. If you are experiencing pain or having difficulty using your hands then early intervention is important to prevent irreversible joint contracture.
Consultation
In the initial consultation Dr Arianayagam will carefully and thoroughly inspect your hands to assess the severity of the condition. Note that Dupuytren’s Contracture is diagnosed based on your history and physical presentation. There is no special testing required.
Once he has completed his assessment, the doctor will recommend treatment. More conservative treatments such as heat, massage and exercise may be recommended before moving to surgery. If the condition is severe, the doctor may recommend moving straight to surgery.
Procedure
The surgery is usually performed on an outpatient basis under general anaesthesia and the thickened fibrous tissue is removed. The surgery is very complicated due to the tissues wrapping themselves around the digital nerves. High magnification loupes (surgical telescopes) are used to ensure surgical precision and the surgery is done with the hands freed of blood with the use of a tourniquet.
If the skin is affected then some relief may be gained by extending the skin using Z-shaped incisions. Alternatively a full thickness skin graft may be necessary.
Recovery
In the first week after surgery your hand will be stabilised with a splint. After one week this is replaced by a compression bandage to prevent any further swelling. Most patients will need to wear the bandage for a period of 3-4 weeks.
You will be able to go back to work after 6 weeks. Avoid extreme stress to the hand from activities such as tennis or golf for 10-12 weeks.
