Dupuytren's fasciectomy
The main aim of this treatment is to rupture or remove the Dupuytren’s bands.
Various forms of treatment can be carried out in people with Dupuytren’s contracture of increasing severity. The more extensive forms of surgery carry progressively higher risks of complications, such as nerve damage, stiffness of the fingers, infection or scarring.
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What is it for?
To rupture or remove the Dupuytren’s bands
Treatment overview
Needle fibrotomy, also called needle fasciotomy:
This is a simple treatment that can be used in mild or severe cases of Dupuytren’s contracture. A needle is used to release the fibrous bands that keep the fingers in a hooked position. The doctor then straightens your fingers (the local anaesthetic will stop you feeling any pain). This releases the remaining fibres so that you can flex and extend your finger normally. This does not require a stay in hospital so you can return to work the next day.
Open fasciotomy The surgeon makes an incision into the palm to get direct access to the thickened connective tissue. Small cuts and slits are made in the tissue to release it, and then the incision is closed. This is done under a local anaesthetic as a day case operation. Recovery takes longer than after a needle fasciotomy.
Partial or complete fasciectomy:
The objective of this operation is to remove the thickened and fibrous connective tissue from inside the palm. It is a more extensive form of surgery done when Dupuytren’s contracture is more severe, or has recurred after having a fasciotomy.
It is done under general anaesthetic. A partial fasciectomy involves removing only the fibrous connective tissue while a complete fasciectomy removes the healthy tissue around it too, so that there is less chance that symptoms will return.
Dermofasciectomy
A complete fasciectomy can be so extensive that the skin of the palm needs to be removed as well. The operation then becomes a dermofasciectomy, which involves grafting skin from another part of the body to replace that removed from the palm.
Injections with collagenase
Collagenase is an enzyme extracted from the bacteria clostridium histolyticum. It breaks down the excess connective tissue that forms in Dupuytren’s contracture.
You can have as many as 3 injections, each a month apart. This treatment is fairly new to the UK, having only been approved since 2011, and the long-term effects will not become clear for some time. RADIATION THERAPY
The National Institute of Clinical Excellence (NICE) has said that radiation therapy may be used in some patients with very mild Dupuytren’s contracture, but that there is not enough evidence to show that it can really be effective.
They do, however, agree to it being an option for people unable or unwilling to have surgical treatment.
Rehabilitation after treatment
Even the most successful treatment is not a quick fix. Some surgeons recommend splints to straighten the fingers after treatment and you are likely to need physiotherapy and to do exercises to increase the flexibility of your fingers for up to six months to get the best results.
Why choose The London Clinic
Excellence in one place
We operate as teams of experts with world-class resources dedicated to maintaining the highest standards of medical care. You are surrounded by the latest treatments and advice with everything you need to get back to your best health.
Personal care, every time
Exceptional patient care is a way of life for us. Our nurses, clinicians and support teams are dedicated to the care of a very small number of patients, so have more time for you. They’ll be with you every step of the way, tailoring your care around you and giving the peace-of-mind that comes with knowing you’re in the best hands.
Effortlessly simple
We work together as one to guide you through each step of your experience, with complexities unravelled and answers readily to hand. Your personal treatment plan will be laid out for you, with all the details taken care of so you can focus on you.
What's included in your package?
Choosing The London Clinic means your treatment plan will be laid out for you, with all the details taken care of so you can focus on you.
Your treatment package will include:
- Enhanced pre-admission assessment
- Your treatment with our complete care team at your fingertips
- Personalised aftercare and follow-up
We want you to be in control of your health. That’s why we also offer optional services such as comprehensive recovery packages and extra touches for you to choose from during your stay with us.
How to pay
- You can use private medical insurance (PMI) to access this treatment. We work with all major PMI providers in the UK and many internationally
- You can pay for yourself (self-pay)
- If you’re paying for yourself, we have finance options available with Chrysalis