North Hampshire Hospital
The Hampshire Clinic
Basingstoke, Hampshire, UK

Mr John Britton FRCS
Consultant Orthopaedic Surgeon

Information for patients undergoing orthopaedic treatment
 


Advice on Dupuytren's Release

Before embarking on Dupuytren's release you should be aware of the following facts. If you have any other questions you should ask your surgeon for further information.

Benefits
Dupuytren's disease is a condition in which scar tissue develops in the palm of the hand, causing progressive contracture of the fingers. Surgery involves excision of the diseased tissue.

  • Surgery is likely to significantly improve the contracture of the fingers, although cannot be guaranteed to give complete correction
  • Surgery is not curative; it is not possible to remove all diseased tissue. Recurrence of contractures is therefore not uncommon

Risks

  • Failure to fully correct deformity: If the contracture is of long standing the finger joints themselves may have become stiff. In this event it may not be possible to obtain a full correction

  • Digital nerve injury: The nerves supplying the fingers are intimately related to the scar tissue and may be injured at the time of surgery. This will result in altered sensation or numbness of the finger tip

  • Recurrent contracture:  Dupuytren's disease is an inherent condition that cannot be cured. Further contractures may therefore develop; these may occur within a year but most patients remain disease free for about 5 years

  • Infection: All surgery carries a small risk of infection; the risk is small and can normally be treated with antibiotics

  • Scar pain:  Scar pain is normal following surgery, but normally resolves after a few weeks. In rare cases pain may be persistent

  • Reflex sympathetic dystrophy:  Extremely rarely a condition known as reflex sympathetic dystrophy (RSD) may develop after surgery; the hand becomes very swollen, painful and stiff. Treatment involves physiotherapy and occasionally injections into the arm. Full recovery from this condition may take may months.

Surgery details

  • Surgery will be done under general or regional anaesthesia. It is not normally possible to do it under local anaesthetic.

  • Incisions are made wherever there is diseased tissue; surgery is often extensive. It may be necessary to apply a skin graft. Alternatively some of the wounds may be left open; these will close naturally over a period of 2 to 3 weeks

  • You may be asked to stay in hospital overnight

  • Most patients will start physiotherapy within a day or so after surgery

  • Dressings are usually required for 1 week

  • Stitches will be removed after about 1 week

Recovery

  • Mild pain is normal for several days following surgery and you may need to take a painkiller such as paracetamol

  • You should keep your hand dry until the stitches are removed

  • You may use the hand as much as you find comfortable

  • You will not be able to do heavy lifting / gardening for about 6 weeks because of pain from the scar

  • You may return to work as soon as you feel able. Office work is often possible within a week of surgery for a minor contracture, but heavy manual work should be delayed for about 6 weeks

  • You may drive as soon as you can comfortably hold a steering wheel / gear stick; this is normally within 1 to 2 weeks of surgery

  • A follow up appointment will be arranged to monitor your recovery

 

For further information please see  www.johnbritton-orthopaedics.co.uk

John Britton FRCS
Consultant Orthopaedic Surgeon
© J M Britton 2007

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