Dupuytren’s Disease and Fasciectomy – PIL1599 Version 1

This leaflet will explain what Dupuytren’s disease is, and the treatment (Fasciectomy) that can be done when the disease affects your hands.

What is Dupuytren’s disease?

Dupuytren’s disease (also known as Dupuytren’s contracture) is a common condition in your hands. The tissue under the skin of your palm thickens over time.

This thickened tissue might develop into a hard lump (nodule). This can then form a ‘cord’ of tissue over time and your fingers can start to curl (contract) into your palm. When this happens you cannot straighten your fingers.

Some people with Dupuytren’s disease might get thickened skin in other parts of their body (e.g. feet and penis). If you do notice this happening, speak to your GP.

What causes Dupuytren’s disease?

The reason behind this disease is not known. It is thought to be genetic because it sometimes runs in families, but it can happen to anyone.

Some people with conditions like diabetes and epilepsy are more at risk of developing the disease, but this is not always the case.

The condition usually affects people in middle age or older, and is more common in men than women.

Do I need treatment?

In many cases, people with Dupuytren’s disease do not need treatment. In most people, it is mild and causes little problems with using your hands.

If your finger has curled (contracted) a lot and you are struggling with everyday activities then you may need surgery to help with the problem.

How do I know if I will need surgery?

If you are able to put the palm of your hand flat on a table then you are not likely to need surgery.

If you cannot put your hand flat on a table and there is a space between the table and your hand, you might need further treatment.

How does the surgery work?

The surgery is called a fasciectomy. A cut is made along your palm and finger so the Surgeon can take the thickened tissue out.

Once the thickened tissue has been removed your finger should be able to straighten.

You might need a skin graft if the thickened tissue has stuck to the skin on your palm. This will be discussed with you if it is needed. It involves taking some skin from an unaffected area and putting it over the damaged area to help it heal.

What can I expect after surgery?

You will have:

• A large bandage on your hand which you must not remove.

• Swelling around the area of surgery. This is normal and should reduce over time. Elevating your hand above the level of your heart can reduce this.

• Pain, which is normal after surgery. Please discuss this with your Hand Therapist.

Before you leave hospital you will be given an appointment with the Hand Therapy Team within 1 week after your surgery. At this appointment your wound will be checked and you will get a smaller dressing. You will also be given a splint to use overnight while you heal.

How do I care for my wound?

Please do not remove any dressings yourself. Your Hand Therapist will assess, check and change your dressing at each appointment. It is important to be careful with the dressing and try to keep it clean and dry. This is to reduce the risk of infection in your wound.

You will have stitches in your wound. Your hand therapist will tell you if they are dissolvable or need to be removed. If they are dissolvable they will be gone in 2 to 3 weeks on their own. If they need to be removed you will be given an appointment.

You should not remove your dressing but if you notice any of the signs below from the area around your wound, please contact the department, your GP, or the Urgent Care Centre as soon as possible.

• Redness.

• Swelling.

• Oozing.

• Bad smell.

• Feeling generally unwell.

What exercises can I do?

At your first appointment after your operation your Hand Therapist will give you specific exercises to complete as part of an exercise programme.

Please do not try your own exercises as this can cause increased pain.

How should I care for my splint?

Your Hand Therapist will make you a plastic splint to wear on your hand at night when you are in bed. This will keep your fingers straight. You will be advised to wear this for approximately 3 months.

You should:

• Keep the splint clean and dry.

• Keep the splint away from sources of heat as this can change the shape of the splint.

• Keep the splint clean with baby wipes or a damp cloth. Do not wash the splint in water.

You should not try to make alterations to your splint.

Please be aware wearing a splint can cause irritation of the skin on your hand. You may notice some rubbing or digging in. If this becomes red, dry or blistered please contact your Hand Therapist. Please bring your splint to each hand therapy session.

How should I care for my scar?

Your Hand Therapist will show you and advise you when to start scar massage. This is normally once the wound has healed and is scabbed over.

Scar massage is useful as it helps to break down the scar tissue. This allows your scar to move more freely and reduces the risk of your scar becoming sensitive.

To complete scar massage you should:

• Apply non-perfumed cream.

• Apply firm pressure in circular movements along the length of the scar.

• Complete the massage for 5 minutes at a time, at least 4 times a day.

When can I return to my normal activities?

Recovery from fasciectomy surgery usually takes between 4 to 10 weeks, depending on how quickly your wound heals, and how quickly your range of movement returns to your fingers.

Your Hand Therapist will guide you through each stage of the healing process.

Do I need to take time off work?

Your Hand Therapist will discuss with you when it is appropriate to return to your normal work and hobbies. Please speak to your GP if you need a sick note. The table below gives you a guide of when you may expect to return to work. This will depend on the type of work or activity you do.

Contact Details

Orthopaedic Outpatient Department

Hartlepool

Telephone: 01429 522590
Monday to Thursday, 8:30am to 5:00pm
Friday, 8:30am to 12:30pm

North Tees

Telephone: 01642 624486
Monday to Friday, 8:30am to 5:00pm

Hand Therapy Team

Telephone: 01429 522471
Monday to Friday, 8:30am to 4:30pm
Saturday and Bank Holidays, 9:00am to 1:00pm

Please contact the Hand Therapy Team:

• If you have any concerns or questions about your exercises.

• If your splint is rubbing, uncomfortable or damaged.

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]