Dupuytren's Disease - Reconstructive Plastic Surgery Melbourne

How is Dupuytren’s Disease Treated?

Surgical treatment of dupuytren’s disease

There are two main procedures to treat dupuytren’s disease- fasciectomy and needle fasciotomy.

In fasciectomy the diseased cords are surgical removed and the surgeon may also perform a joint release when a joint is immobilised in a flexed position. Fasciectomy is the most successful of treatments, however there is risk of recurrence of approximately 20% within 4 years.

For patients who will not tolerate a full fasciectomy, a limited fasciectomy will remove a small amount of the diseased tissue and correct the flexed finger deformity. While there’s a high recurrence rate with this surgery, it’s commonly performed on elderly patients who aim to improve hand function.

The second type of procedure is called needle fasciotomy. In this procedure, the hand is anaesthetised and then a needle is used to divide the fibres in the cord until the finger can be stretched to a straighter position. This is safest when performed in the palm (rather than the fingers) and while it does not remove the diseased cords, it stops them from pulling down on the affected fingers. This is generally well tolerated by most patients, including the elderly and those with pre-existing medical conditions. It can provide a good functional benefit, but has a higher rate of recurrence than fasciectomy.

Our RPS surgeons will conduct a thorough assessment and determine whether any of these approaches is right to manage your Dupuytrens disease.

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Recovery and Rehabilitation

After your surgery, you may be in a splint for a week or so and may need hand therapy, night splints and exercises to do at home to assist with your recovery.

You may be able to return to work in as short as one to two weeks. This will depend on the type of duties and whether you need to use your hands.

If you need to do heavy lifting or use your hands extensively, you may need a longer recovery period, particularly if your surgery was extensive and/or involved multiple digits. Your surgeon will recommend a suitable recovery time.

More information

What else you should know

Are there non-surgical treatments for dupuytren's disease?

Some patients find relief from the enzymatic drug Collagenase being injected into the diseased tissue (Xiaflex). Collagenase works to break down collagen and soften and weaken the contracture. However, it is not currently on the Pharmaceutical Benefits Scheme, and these injections are no longer available in Australia.

Needle fasciotomy (using a fine needle to divide the cords and allow straightening of the finger) can be performed under local anaesthetic in the consulting rooms.

Can Dupuytren's Disease reoccur after a surgery?

Surgery does not cure the tendency for patients to form Dupuytrens cords. It is very effective at removing or dividing these cords so that hand function and appearance are optimised. Removal of the cords (fasciectomy) produces the best long-term results. While Dupuytrens can reoccur in the same digit, most patients will not require further surgery on the same finger after fasciectomy, but other digits may become involved over time. Patients differ in the speed of forming new Dupuytrens cords and your surgeon will discuss your risk profile with you before surgery.

What are the risk factors for dupuytren's disease?

The main risk factor for Dupuytren’s disease is a strong family history of Dupuytrens disease. Relative risk factors include diabetes, hand trauma, smoking, epilepsy and age. Dupuytren’s disease is more common in men and most individuals notice the disease in their little and/or ring finger.

How will RPS manage my post-operative care?

Your RPS surgeon will give you specific advice regarding your individual post-operative recovery. They will advise:

where you will go after your surgery
what medication you will be given or prescribed
what bandages and dressings you will need and when they’ll be removed
if you require stitches, when they’ll be removed
when you can get back to normal activity and exercise
when to book your follow-up care.

Dr. Michael Findlay

Our Melbourne specialist

The team at RPS Melbourne are committed to providing you with the best possible outcome.

The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.

Dr Michael Findlay holds an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.

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