Dupuytren’s Contracture

What is it?

It is a condition in which one or more fingers become permanently bent in a flexed position. It usually begins as small hard nodules under the palmar skin. The reason why the palmar aponeurosis hardens is unknown. The gold standard in treatment is surgical fasciectomy or fasciotomy; however, injectable collagenase is a minimally-invasive alternative.

The procedure

I perform zig-zag skin incision on the palmar surface of the bent finger and excise the contracted fascia, so as the finger regains its range of movement immediately. I use magnifying loupes to recognize and protect the small digital nerves and vessels.

Anesthesia

Axillary block (Awake patient).

Recovery

The hand is bandaged and elevated to reduce swelling. I recommend that movement of the fingers starts immediately. However, weight lifting and heavy exercise is permitted after 1 month. Sutures are removed 10 days post-op.

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ThessalonikiChios