Dupuytren's Fascietomy
Dupuytren’s Fasciectomy
Patient Information
Upper Limb Unit, Wrightington Hospital
- Author ID: CF
- Leaflet ref: UL 015
- Version: 5
- Leaflet title: Dupuytren’s Fasciectomy
- Last review: June 2025
- Expiry Date: June 2027
Introduction
This leaflet aims to help you understand and gain the maximum benefit from your operation. Please be aware that each person’s operation is individual, and you may be given instructions specific to you that are not contained within this leaflet.
What is Dupuytren’s Contracture?
Dupuytren’s contracture is a complaint that affects the hand. Initially it develops as nodules
(lumps) under the skin in the palm of the hand, just below the fingers. Over time the
nodules form a thick band of tissue which shrinks, pulling one or more fingers towards the palm. Eventually, the fingers may become difficult to straighten, which can lead to problems performing daily tasks.
The cause of Dupuytren's contracture is not fully understood; it develops more often in
men than women and is known to run in families. It is associated with liver disease,
diabetes, alcohol dependence and smoking, but many people who develop Dupuytren’s
contractures have none of these factors. It may also occur following injury or surgery to the
hand or wrist.
The treatment of Dupuytren’s contracture will depend on the severity of your condition.
Mild symptoms may not require treatment or may benefit from a needle fasciotomy. This is where a fine needle is used to make small puncture holes in the thick tissue that is causing the contracture.
If the symptoms are causing more severe problems with hand movement and function, a fasciectomy operation can be a more effective treatment. This involves a straight or zigzag cut to your palm and finger to allow the surgeon to cut or remove the thick bands of tissue that are causing the contracture. Occasionally, in more advanced cases, a skin graft is taken from your forearm and moved to your hand to help with healing.
The surgical options suitable for you will be discussed with you in clinic.
Benefits
Following the operation, your affected fingers should be straighter, enabling better function.
Risks
As with all operations there can be complications, some minor and some serious, and in
rare cases may be life threatening.
Specific complications of surgery for Dupuytren’s contracture include:
- Recurrence of the condition
- Incomplete correction of the contracted fingers
- Stiffness in the finger joints
- Numbness due to damage of nerves that are situated close to the operation site
All of the above can improve but sometimes you can be left with sensitivity to cold in the affected fingers.
General complications associated with surgery include:
- Bleeding
- Wound infections which are treated with antibiotics
- Scarring of the skin over the operation site
- Complex Regional Pain Syndrome
The doctor will discuss with you the risks involved prior to the operation.
About the operation
The operation is performed as a day case so you can return home the same day. There are different types of anaesthetics that can be used, and the doctor will discuss the options with you before the operation. The skin will be closed using stitches (sutures). A bulky dressing or plaster is then applied to your hand.
After the operation
After the operation you will spend a short time in the recovery ward of theatre. You will then be taken back to the ward. Your hand may cause some discomfort following the operation. You will be given advice regarding pain relief medication.
Before you are discharged you will receive an appointment to return to the hospital to see the team for removal of the dressing and to check your wound. If not absorbable, the stitches will be removed 10-14 days after surgery.
Swelling
You should aim to keep your arm elevated to reduce the swelling. Resting your hand by using pillows underneath it while sitting in a chair or in bed at night will also help with this.
Wound and Scar Care
Your wound should always be kept dry until the team advise you that you may start to get it wet. This will be after the stitches are removed.
Once the stitches have been removed and the wound is fully healed, you should start to massage the incision with unperfumed cream to soften and flatten the scar. This will allow better movement of your fingers.
Exercise
You will be shown exercises by your therapist at your first appointment and throughout your treatment. The main aim of these is to regain the movement and strength of your fingers and hand. It is very important that you work on the exercises you are given correctly and follow the instructions given by your therapist.
You should aim to exercise in short frequent sessions rather than one long session. Aim for the repetitions that the therapist advises.
Splint
A splint may be made for you to wear at night to maintain the straighter position of your fingers achieved in surgery. The splint is designed to prevent the surgical scar from contracting during the healing process. You should wear the splint at night for as long as you feel that it is helping to keep your fingers straight. This is usually around 6 months.
You should bring your splint with you to each therapy appointment as it may need refitting over time.
Activities and Work
Your ability to use your hand will depend on pain, movement, strength and the wound healing. You can use your hand for daily tasks as soon as you are comfortable and can increase your use of the hand as pain and swelling allow.
Returning to work will depend on wound healing and recovery of hand movement and strength. It will also depend on the type of work you do. Any questions regarding specific activities will be answered by your therapist or surgeon.
Driving
You should be in complete control of your car at all times. You can return to driving as soon as you assess yourself as being safe to do so.
Contact details:
Wrightington Therapy Department
01257 488272
08:00-16:30 Monday to Friday
Leigh Health Centre Therapy Department
0300 700 1597
08:00-16:30 Monday to Friday
Boston House
0300 707 1113
wwl-tr.mskphysio-bostonhouse@nhs.net
08:00-16:30 Monday to Friday
Ward One
Monday to Friday, 7.30am – 8pm
01257 256272
Male Bay 01257 488272
Female Bay 01257 256551
Outpatient appointments:
01257 256222 or 01257 256241