Removal of nodules and cords in Dupuytren's disease
- Method
- Fasciectomy for Dupuytren's disease
- Duration
- 90 minutes
- Recovery time
- 2 to 3 weeks
Dupuytren surgery is a surgical procedure for treating Dupuytren's contracture, a condition in which the connective tissue of the palm thickens and pulls the fingers into a bent position. The aim of the operation is to remove the contracted cords and restore the movement of the fingers.
Dupuytren's disease is a benign condition of the connective tissue that occurs above all in men over the age of 50. It can lead to an increasingly bent position of the fingers, which considerably restricts the grip of the hand.
How does Dupuytren surgery work?
To give a clear view, the operation is carried out in a bloodless field and with magnifying loupes. Depending on how far the condition has progressed, the extent of the procedure can vary considerably. Sometimes it is enough to remove individual cords of connective tissue. In advanced cases it may be necessary to remove the whole plate of connective tissue in the palm (fasciectomy).
In addition, adhesions around nerves, blood vessels and joint capsules sometimes have to be released carefully during the operation. So that the scar does not later cause the connective tissue to shrink again, a Z-shaped incision is usually made. At the end of the operation small drains are placed to let the wound fluid out; these are removed again after 1-2 days.
Rehabilitation after Dupuytren surgery
Aftercare following Dupuytren surgery is decisive for long-term success. Early mobilisation and targeted physiotherapy are important in order to preserve the movement of the fingers and avoid a recurrence.
Phase I (weeks 1 to 2): wound healing and early mobilisation
The first phase is dominated by wound healing. The hand is elevated and cooled. Gentle mobilisation exercises for the fingers are possible on the very first day, in order to avoid adhesions. The dressings are changed regularly.
Phase II (weeks 3 to 4): functional mobilisation
The second phase comprises targeted physiotherapy to improve movement and strengthen the muscles of the hand. Stretching exercises and manual therapy help to restore full extension of the fingers.
Phase III (weeks 5 to 6): building up load
Phase III focuses on taking up everyday activities again and on improving the grip. Fine-motor exercises and targeted strengthening exercises are intensified.
Phase IV (from week 7): long-term care
The final phase aims to preserve the improvements achieved over the long term. Regular check-ups and, where needed, further physiotherapy help to avoid a recurrence.