The post Dupuytren’s Contracture appeared first on PCLS Coffs Harbour.
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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.
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How can it help?
The cause is unknown but it is thought that small tears in the tendon membrane or joint capsule caused by overuse or trauma cause the contents to squeeze out.
Occasionally ganglion cysts go away by themselves. However, where cysts persist or affect daily life, surgical removal is recommended. Surgery must be done meticulously to avoid the not infrequent recurrence of the problem.
Procedure
The surgery is usually performed at the Coffs Harbour Day Surgery or Baringa Private Hospital under general anaesthesia and with the use of a tourniquet to give good vision. The procedure can be difficult if the cyst is multi-loculated.
Recovery
Depending on the location of the excised ganglion cyst, full recovery can take anywhere from 2 to 8 weeks. You will be fitted with a splint for about one week, after which you will be encouraged to get the joint moving again, but with some restriction.
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How can it help?
IPL and CO2 Laser treatments use light to improve skin tone, reduce age spots and correct prominent blood vessels. The light is delivered to the deeper parts of the skin (dermis), leaving the superficial surface of the skin (epidermis) undamaged.
Consultation
During the initial consultation Dr. Arianayagam will carefully and thoroughly examine your hands. He will also ask you a variety of questions about your current health situation, medications, allergies and any past medical treatments.
He will then discuss the options available and his recommendations. You should feel free to frankly discuss your goals and expectations and ask plenty of questions.
Treatments
IPL treatments are conducted at the Scarba Street Clinic. Treatments take from 20 to 30 minutes and there is no downtime. Multiple treatments are required to get the best results.
CO2 Laser hand resurfacing is done under general anaesthesia as a day surgical procedure at the Coffs Harbour Day Surgery and you will need dressings for 5 to 10 days.
Recovery
After IPL treatment you should expect your skin to be red and there may also be some swelling. Some people experience stinging or itching, which subsides after 12-72 hours.
After CO2 Laser treatment, protective dressings are applied over the treated area. These remain for 5 to 7 days and are changed as required.
While your hands are healing you will be asked to apply moisturiser to the treated area to keep it soft, and to avoid all sun exposure. The downtime will depend upon the depth and breadth of the treatment. Dr. Arianayagam will discuss this during your consultation and at the time of treatment.
After treatment it is critical to keep your hands well moisturised and use a broad spectrum sunscreen to protect the new skin.
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