What is Dupuytren’s contracture?
Dupuytren’s contracture (otherwise known as Dupuytren’s disease) is a condition that causes thickening of the tissue and development of knots along the palm of your hand. These knots merge to form a cord of tissue which can eventually pull your finger(s) down and prevent them from straightening.
This disease usually develops over years, affecting ring and little fingers, and can occur in both hands. In severe cases of Dupuytren’s contracture, the finger(s) can get stuck in a bent position.
Although there are some treatment options that slow the knots developing, there is no cure for Dupuytren’s contracture and the most common form of treatment is surgery.
Who is Dupuytren’s contracture treatment for?
The reasons for considering Dupuytren’s contracture surgery will be determined by the effect the disease has on your everyday life. Some of them may include:
- You cannot place your hand flat.
- It’s a struggle getting your hand into tight spaces.
- Shaking hands with others is uncomfortable or difficult.
- Wearing gloves is almost impossible.
- You can’t put your hand in your pocket.
- It becomes difficult to pick things up or hold them safely.
The first step is to make an appointment to see Dr McMillan.
You will meet Dr McMillan at his private rooms in Fernbrae House, Dunedin or in Invercargill to review your Dupuytren’s contracture and discuss the best surgical options. This is an important step; not only gaining an understanding of the expected surgical outcomes but also developing your relationship with Dr McMillan as you work together to establish better function for your hand.
Depending on the extent of the Dupuytren’s, your hand may only need a simple cut to release the tension; or it may need a larger cut to remove tissue; or it may need an even larger cut that removes tissue and then needs a skin graft. You will have an opportunity to discuss all of this with Dr McMillan before surgery.
Once you have decided on what is to be done, a date will be booked for you at Mercy Hospital, Dunedin to have your Dupuytren’s contracture surgery.
The procedure will involve having a general anaesthetic. In some rare cases this procedure can be done under local anaesthetic. Once you are asleep or the area is numbed, a surgical cut will be made in the palm of your hand that will release the tension and/or remove the thickened tissue.
Sometimes the thickened tissue and skin cannot be separated and in cases like this, a skin graft (taken somewhere else on your body) may be used to replace the skin.
Sutures are placed along the areas the Dupuytren’s has been released or cut out, and any area a skin graft may have been taken from.
Dressings will be placed over the suture lines and your hand will be wrapped in a bandage.
Dupuytren’s contracture surgery is usually a day surgery procedure. You will not need to stay overnight at the hospital.
Recovery will depend on how much surgery was needed to release the thickened tissue.
Skin healing will occur over a couple of weeks and the scarring should be minimal. Most of the recovery time will be dedicated to making sure your hand restores as much function as possible. You and your hand will need to follow an exercise program and may need physiotherapy for up to 8 weeks following surgery.
In some cases, you may need to wear a splint to prevent your hand contracting again.
It is not uncommon for there to be pain, stiffness and swelling for about a month after surgery. This will fade over time and the function of your hand will return.
If the Dupuytren’s contracture is quite advanced, the finger may still remain a little bent, but the aim is to minimise this as much as possible.
There will be scars along the palm of the hand, which will fade over time.
It is possible for Dupuytren’s contracture to return. Dr McMillan can talk to you about treatment options to reduce the risk of this happening.
Risks and complications
As with all surgical procedures there are risks and potential complications with Dupuytren’s contracture surgery. Dr McMillan will discuss all of these with you during your consultation and answer your questions.
There is a cost to having Dupuytren’s contracture done privately. The exact figure will depend on a range of factors but generally the cost is between $9,000 and $14,000.
If you have Dupuytren’s contracture start the journey to better function for you and your hand; get in contact to make an initial consultation with Dr McMillan about surgical treatment.