FREQUENTLY ASKED QUESTIONS
Q. Fasting before Operation?
A. Nothing to eat or drink at least 6 hours before the operation.
Q. Anaesthetic?
A. General anaesthetic or arm block anaesthetic can be used.
Q. Duration of Operation?
A. About 60 minutes.
Q. Pain?
A. Usually, local anaesthetic is also administered at the time of surgery. You will be given oral pain relief to take home with you.
Q. Will I be in a plaster after the operation?
A. Usually a plaster will be placed on your hand for comfort and to hold the fingers straight.
Q. Will I need physiotherapy after surgery?
A. The final result from surgery depends as much on expert hand therapy as it does on expert surgery. An appointment will be made for you to attend hand therapy a few days after your operation, to remove the dressings and commence movement.
DUPUYTREN’S DISEASE
WHAT IS IT?
Dupuytren’s disease is an abnormal thickening in the palm that may limit movement of the fingers. In serious cases, a cord forms beneath the skin that stretches from the palm into the fingers.
The cord causes the fingers to bend into the palm so they cannot be fully straightened. Sometimes, the disease will affect other areas of the body - such as the knuckles of the fingers, the soles of the feet or the penis.
WHAT CAUSES IT?
The cause of Dupuytren's is unclear, however there is a strong genetic component. At present there is no permanent cure. Dupuytren's disease mostly affects white people with ancestors from Northern Europe. It occurs more often in men than in women, and usually starts after age 40. In many cases, the disease runs in families.
Some people may develop a more severe form of Dupuytren's disease. These may be people who:
• develop the disease at a young age
• have the disease in areas other than the hand,
• have a strong family history of the disease.
Injuries, vibration or long-term heavy use of the hand have not been directly linked to causing the disease, although hand surgery or trauma may increase its rate of progression.
HOW DOES IT AFFECT ME?
Dupuytren's disease usually shows up as a small lump or pit in the palm. This tends to occur near the crease of the hand that is closest to the base of the ring and little fingers. With time, the cord may develop between the palm and the fingers.
The disease is usually noticed when the palm cannot be placed fiat on an even surface, such as a tabletop. In severe cases, drawing of the fingers into the palm interferes with everyday activities, like washing hands, wearing gloves, and putting hands in pockets.
HOW DOES THE DISEASE DEVELOP?
• The disease most often begins in the palm of the hand at the base of the ring or little fingers.
• The lump or pit may show up months or even years before the cord develops from the palm to the fingers.
• Having the disease in both hands is common.
• Drawing of the fingers into the hand can occur at the joints at the base of the fingers, or the joints in the fingers.
• The skin may be involved with the disease, but the tendons in the hand are not affected.
CAN IT BE TREATED?
There is no permanent cure for Dupuytren's disease. Currently, there is no tablet or injection that is of benefit. Surgery can relieve the bending of the fingers into the palm, but the condition can return with time. The goal of surgery for Dupuytren's disease is to restore movement of the fingers.
Some considerations on surgery:
• Presence of the lump in the hand does not mean that surgery is required.
• Bending of the fingers into the palm at the base of the fingers is usually correctable by surgery.
• Surgery may not completely relieve bending at the joints in the fingers.
• It is important to remember that surgery is not a permanent cure for this disease. After surgery, thickening of the palm and development of the cord may return in the same place, or at a new place within the hand.
• It is extremely important to attend skilled hand therapy after surgery, as this will greatly improve your outcome