Dupuytren Contracture

What is Dupuytren?

The thickening of the healthy tissue in the palm, which is mostly seen in men over the age of 50 with white skin, and the person’s inability to move his fingers in advanced situations can be answered to the question of what is Dupuytren. First of all, the changes that start with a small nodule (swelling, hardness) on the palm expand over time and the patient becomes unable to fully open and move his fingers. Dupuytren’s contracture occurs when the patient’s connective tissue loses its flexibility and has difficulty moving their fingers. The disease, which is generally painless, may be uncomfortable in some patients in the form of minor aches and pains. The disease does not regress or recover on its own, and there is a possibility of recurrence of the disease after Dupuytren’s surgery. As Dupuytren’s disease progresses, the person cannot perform actions such as holding objects, washing hands, as the adjacent tissues and nerves of the fingers are affected; It is time for a dupuytren surgery. When the patient places his palm on a flat surface, he cannot fully touch the floor and the hand forms a domed protrusion. Although the causes of Dupuytren’s disease are not known exactly, it is stated that alcohol use, diabetes, systemic diseases, genetic transitions, smoking and jobs that require continuous use of the palm are seen as risk factors.

How Is Dupuytren’s Surgery Performed?

In order to obtain successful results in Dupuytren’s surgery, the cases must be handled without further progress. If there is a situation that prevents the palm from touching the ground properly, dupuytren surgery should be performed without delay. Before the operation, the areas that are damaged and where the operation will be performed are determined. The thickened layer in the palm is removed while protecting the nerves and vessels. Then, the incisions are stitched and the surgery is completed. This tissue must be repaired so that the person can move his / her fingers easily in the disease that results in the tendons sticking together in the thickening of the fascia in the palm. In Dupuytren’s Disease, with the separation of the adherent tendons, the patient can easily move their fingers. Sometimes, after the removal of the damaged tissue in the operation, the skin surface may be reduced. If such a situation occurs during Dupuytren’s surgery, then the skin is removed from another part of the body and a skin patch is applied to these missing surfaces.

What Should Be Considered After Dupuytren’s Treatment?

In this disease, it is a type of surgery that should be done very carefully because the nerves in the finger usually surround the damaged tissue. As there is a risk in every operation, there are always risks such as nerve damage and bleeding in dupuytren surgery. In such surgeries performed by numbing the arm under the armpit, usually under local anesthesia, patients can often be discharged on the same day. After Dupuytren’s surgery, a plaster splint is made that allows light dressing of the treated area and prevents movement. The plaster splint should be used carefully in order to avoid any distress in the surgical area. A 10-day recovery period is sufficient for this. Dupuytren surgery, which requires special attention, experience and the use of microsurgical techniques, is the most important factor in obtaining effective results. If you or your relatives have symptoms of Dupuytren’s disease, you can contact Aesthetic and Plastic Surgery Specialist Dr. Mahmut Sunay who is a specialist in the field, and also a Microsurgeon.