Dupuytren’s disease – Treatment

Procedure

This requires cutting the cords that lead to bending of the fingers. If these strands are superficial and easily palpable under the skin, they can be cut through the skin (percutaneously) using needles (needle fasciotomy).

If the cords cannot be felt with certainty, they must be removed via larger incisions in the palm area. In more severe cases, the shortened joint capsules of the finger joints often have to be loosened. Sometimes a small skin graft or displacement is needed to close the affected area completely.

When should the operation be performed?

Surgery is usually recommended when it is no longer possible to lay the hand flat on a flat surface. If treatment is delayed too long, it may no longer be possible to achieve full extension of the fingers. Nodules alone without flexion deformity of the fingers, on the other hand, should only be operated on if they really cause discomfort, as the scarring can sometimes be disturbing. Since the recurrence rate is relatively high even with radical surgery, surgery should not be performed too early.

Aftercare

In order to achieve the best possible result, consistent follow-up treatment is required. This consists of wearing a night splint for three to six months. Depending on the findings, a splint is also worn during the day for the first two to six weeks. In hand therapy, movement exercises are regularly instructed and scars are treated. Full weight bearing is possible after the wound has healed, i.e. after approx. two to four weeks.