Dupuytren’s contracture surgery Perth
Dupuytren’s contracture surgery
Dupuytren’s disease causes the tissue in the palm to thicken and tighten, gradually pulling one or more fingers into a bent position. Over time this can make everyday tasks like placing your hand flat, wearing gloves, or gripping objects more difficult.
At the Wrist + Hand Institute in Perth, we assess Dupuytren’s disease thoroughly and explain when hand surgery or a minimally invasive release may be worth considering.
Understanding Dupuytren’s disease
Dupuytren’s disease affects the tissue just under the skin of the palm. Over time this tissue can thicken and tighten, forming cords that slowly pull one or more fingers into a bent position. The ring and little finger are most commonly involved.
The condition develops in the palmar fascia, the layer of supportive tissue beneath the skin of the palm. In some people this tissue becomes thicker and shorter over time. Dupuytren’s is a genetic condition.
Many people first notice a small lump in the palm. As the condition progresses, a firm cord forms under the skin and gradually pulls the finger toward the palm, making it harder to straighten the hand.
Early stage of Dupuytren’s disease
A small lump or thickened patch may appear in the palm. It can feel firm under the skin but the fingers usually still move normally. At this stage many people simply notice a change in the feel of the palm.
Developing stage of Dupuytren’s disease
Advanced stage of Dupuytren’s disease
Even though the cause is different, both osteoarthritis and rheumatoid arthritis can affect function in the wrist, hand and fingers. Surgical options are available for both osteoarthritis and rheumatoid arthritis. The type of surgery depends on the location of the arthritis and which joints are involved.
Dupuytren’s contracture Perth
When is Dupuytren’s contracture surgery considered?
Not every case of Dupuytren’s disease needs surgery straight away.
Dupuytren’s disease treatment is usually discussed once the finger becomes harder to straighten, everyday hand use starts to change, or the contracture continues to progress. A consultation helps determine how severe the disease is, which joints are involved, and whether a minimally invasive release or open surgery is more suitable. Each case of Dupuytren’s is different in terms of how fast the condition progresses. Measurement and individual assessment are key.
The right treatment depends on several things, including:
- how bent the finger is
- how rapid the condition is progressing or extending to other fingers
- how many fingers are involved
- whether the disease is mild, moderate, or severe
- whether the skin is also affected
- whether this is a first procedure or a recurrence
Dupuytren’s release surgery
Types of Dupuytren’s surgery and release options
There is no single operation that suits everyone. The main options for Dupuytren’s contracture surgery in Perth include the following.
Percutaneous release
Percutaneous release is a minimally invasive option that may be suitable in selected cases. A needle is used through the skin to divide the tight cord and release the contracture.
It is usually considered for selected cases where the cord is well defined and the pattern of disease is suitable. Recovery is often quicker because there is no large incision. It is performed as a day case under local anaesthetic.
Fasciectomy
This is an open surgery where the diseased tissue is removed through an incision in the palm or finger.
A fasciectomy is commonly used when the disease is more established or when a more complete release is needed. It allows the hand surgeon to directly see the cord, protect nearby nerves and vessels, and straighten the finger as much as possible.
Dermofasciectomy
This is usually reserved for more severe disease, recurrent disease, or cases where the skin is involved. The diseased tissue and affected skin are removed, and a skin graft is used to cover the area.
Dermofasciectomy is a more extensive procedure, but it can be useful in selected cases where a standard operation may be ineffective.
Dupuytren’s disease hand surgeon
What happens during Dupuytren’s surgery
The procedure depends on the type of release being performed. In simple terms, the goal is to divide or remove the tight tissue that is pulling the finger down.
For open surgery, the incision is planned carefully to allow safe access to the diseased cord while protecting important structures in the hand. Once the contracture is released, the finger is straightened as much as the tissue and joints allow.
The aim is to improve finger position and hand function where possible, although results vary between patients. In more advanced cases, full correction is not always possible, especially if the joint has been bent for a long time. Your orthopaedic surgeon will discuss what is a realistic outcome based on your specific condition.
Percutaneous Dupuytren’s release
Recovery after Dupuytren’s contracture surgery
Recovery after Dupuytren’s contracture surgery depends on how advanced the condition was and which procedure was performed.
Percutaneous release
Recovery after percutaneous release is usually quicker because the cord is divided through the skin with a needle. Light hand use often returns within days. Hand therapy may still be recommended to help restore finger movement and maintain extension.
Open surgery or dermofasciectomy
Open surgery involves removing the diseased tissue through an incision in the palm or finger. Healing takes longer because the skin and deeper tissues need time to recover. Hand therapy helps reduce stiffness, improve finger movement, and support scar care. Your surgeon will provide information outlining the recovery after dermofasciectomy based on your specific case.
Surgery Risks
All surgery carries some risks. With Dupuytren’s contracture surgery these can include infection, bleeding, nerve irritation, stiffness, delayed healing, or recurrence of the contracture over time. Our hand surgeons will discuss these risks with you and explain what they mean for your hand and recovery.
Hand and wrist surgeon Perth
When to seek advice
A lump in the palm, a firm cord under the skin, or a finger that slowly starts to curl down can be early signs of Dupuytren’s disease. Having the hand assessed early helps us understand how advanced the condition is and what treatment may help.
The Wrist + Hand Institute Perth provides assessment and treatment for Dupuytren’s contracture surgery, including percutaneous release and open surgery when needed. Our team operates at several Perth hospitals including Bethesda Hospital in Claremont, Hollywood Hospital, South Perth Hospital, and Sundew Day Surgery.
Hand and wrist surgeon Perth
Frequently Asked Questions
Does Dupuytren’s contracture surgery straighten the finger completely?
The aim of Dupuytren’s contracture surgery is to improve finger position and hand function. Many people notice a clear improvement in how straight the finger sits. Full straightening is not always possible when the joint has been bent for a long time. Your surgeon will examine the finger and explain what improvement is realistic for your hand.