Dupuytren’s contracture is a hand condition that causes one or more fingers to bend inward toward the palm, making it difficult to fully straighten the hand. Over time, this tightness can interfere with everyday tasks like gripping objects, shaking hands, or even typing. While early stages of Dupuytren’s contracture may be managed with non-surgical treatments, surgery is often recommended when the condition progresses and begins to restrict hand movement. This article explains how Dupuytren’s contracture surgery works, its benefits in reducing finger tightness, and how it differs from other conditions such as nerve palsy in Hatfield that also affect hand function.
Understanding Dupuytren’s Contracture
Dupuytren’s contracture is caused by the thickening of connective tissue under the skin of the palm and fingers. This thickening creates fibrous cords that gradually pull the fingers into a bent position. The condition usually affects the ring and little fingers but can involve other fingers as well.
The exact cause is not fully known, but it is linked to genetic factors, as it often runs in families. It is more common in men over the age of 50 and tends to progress slowly over several years. Other contributing factors include smoking, diabetes, and certain medications.
When Surgery Becomes Necessary
In the early stages, treatment may include stretching, splinting, and injections to soften the cords and slow the progression. However, if the contracture becomes severe enough to limit daily activities, surgery becomes the most effective way to restore finger mobility.
Signs that you may need Dupuytren’s contracture surgery include:
- Difficulty laying your hand flat on a table
- Noticeable lumps or cords in the palm
- Fingers becoming permanently bent
- Increasing discomfort or stiffness
The goal of surgery is to release or remove the tight cords that restrict finger movement, allowing the hand to open more freely.
Types of Dupuytren’s Contracture Surgery
Limited Fasciectomy
This is the most common surgical procedure. The surgeon makes small incisions in the palm and fingers to remove the thickened cords and affected tissue. This helps release the tension that causes finger bending.
Needle Aponeurotomy
A less invasive option, this technique uses a fine needle to puncture and divide the cords. It can be performed under local anaesthesia and typically allows for quicker recovery, though there is a higher chance of recurrence compared to traditional surgery.
Dermofasciectomy
In more advanced cases, the surgeon removes both the affected tissue and the overlying skin. A skin graft from another area of the body is then used to cover the wound. This method helps reduce the risk of the contracture returning.
The Surgical Process
During Dupuytren’s contracture surgery, the patient is usually given local or regional anaesthesia to numb the area. The surgeon then carefully identifies and releases the fibrous cords, preserving nearby nerves and tendons. The complexity of the procedure depends on the severity of the contracture and how many fingers are affected.
Once the cords are released, the fingers can often be straightened significantly, and normal function gradually returns as swelling subsides. Stitches are removed after about two weeks, and physiotherapy usually follows to help restore movement and strength.
Recovery and Rehabilitation
Recovery from Dupuytren’s contracture surgery varies depending on the type of procedure and the extent of the contracture. Most people experience significant improvement within a few weeks, though full recovery can take several months.
A structured rehabilitation program is essential. Hand therapy, including stretching and strengthening exercises, helps maintain finger flexibility and prevent stiffness. Wearing a splint at night may also be recommended to keep the fingers extended while healing.
Benefits of Dupuytren’s Contracture Surgery
The most noticeable benefit is improved finger mobility. After surgery, patients can typically:
- Straighten their fingers more fully
- Grip and hold objects comfortably
- Perform tasks that were difficult before surgery
Additionally, the surgery can relieve pain and discomfort associated with tightness in the palm and fingers. For many patients, the improvement in hand function significantly enhances their quality of life and independence.
Risks and Complications
As with any surgical procedure, there are potential risks. These can include infection, scarring, nerve injury, or recurrence of the contracture. While recurrence is possible, especially in cases where only a partial release is done, careful surgical planning and diligent post-operative care can minimise these risks.
Patients with pre-existing hand conditions such as nerve palsy in Hatfield may experience slower recovery, as nerve-related issues can affect muscle control and sensation. This is why a thorough assessment by a hand specialist is crucial before surgery, ensuring that the treatment plan addresses all underlying problems.
Difference Between Dupuytren’s Contracture and Nerve Palsy
Although both conditions can cause hand weakness or limited movement, Dupuytren’s contracture and nerve palsy are fundamentally different. Dupuytren’s contracture affects the connective tissue, while nerve palsy results from nerve damage that impairs muscle control.
For example, ulnar nerve palsy can cause weakness in the ring and little fingers, mimicking Dupuytren’s contracture. However, in nerve palsy, the fingers are not pulled inward by cords but instead cannot be straightened due to loss of nerve function. Correct diagnosis ensures that patients receive the right treatment—whether that is surgery for tissue release or nerve repair.
Choosing a Specialist in Hatfield
If you are experiencing symptoms of finger tightness or loss of movement, consulting a hand surgeon in Hatfield can help identify the cause and appropriate treatment. Specialists can determine whether Dupuytren’s contracture surgery or nerve-related therapies are needed, ensuring a tailored approach for optimal recovery.
Conclusion
Dupuytren’s contracture surgery provides a reliable solution for reducing finger tightness and restoring hand function. By releasing the thickened cords that pull the fingers inward, patients can regain flexibility and comfort in their daily activities. While conditions like nerve palsy in Hatfield may present similar symptoms, accurate diagnosis and expert surgical care ensure that the most effective treatment is provided. With proper rehabilitation and follow-up, most patients experience long-term improvement in hand strength, function, and quality of life.
