Limited Palmar Fasciectomy for Dupuytrens Contracture

Overview

This surgical procedure is performed to treat fingers that have become flexed because of Dupuytren’s contracture. In this procedure, the thickened and contracted part of the fascia – the layer of tissue just beneath the skin – is removed. There are many variations of this surgery based on the severity of the condition.

Preparation

The patient is positioned so that the palm of the hand is clearly visible to the surgeon. A regional pain block is often administered prior to general anesthesia. The hand is cleansed and sterilized and a tourniquet is applied.

Removing the Fascia

One of several types of incisions is made to access the fascia of the palm and the involved fingers. Digital nerves and arteries are identified and protected. The thickened cords of the fascia are then carefully removed to allow the finger to extend more normally. If the skin is severely affected by the contracture, the skin may be removed and a skin graft applied.

End of Procedure

The incision is usually closed with sutures. In some cases, the incision may be left open to drain. If the wound is closed, a small drain may be placed under the skin. A bandage and splint are applied. Elevation of the hand after surgery is recommended. Most patients are able to go home the same day. Hand therapy will be required.