Private Dupuytren’s contracture release

Dupuytren’s contracture is a condition which affects the hands and fingers (but can also occur in feet) and happens when the connective tissue changes in the hand, and becomes thickened forming bands and cords.

Over time Dupuytren’s contracture can cause one or more fingers to bend towards the palm, and the connective tissues in the palm to thicken and cause a cord-like a rope in the palm. Similar cords/bands can also extend into the fingers.

• It mainly affects the ring and little fingers
• You can have it in both hands at the same time
• It gets slowly worse over time
• It begins with lumps or ridges on your palms
• Eventually your fingers bend in towards the palm
• It can affect other parts of your body in its more aggressive types

Dupuytren’s contracture has a profound effect on an individual’s ability to function. If you feel that your unable to straighten your fingers than you should seek advice from your GP.

Surgical release is the most common form of treatment although other forms of treatment include needle release or injection. A surgical release involves removing the thickened bands, Dupuytren’s tissue (all or a part of it) and straightening the affected digit (finger). This is carried out mostly under general anaesthesia or a regional block.

Injection involves a drug called Xiapex. Xiapex is injected directly into the cord of connective tissue, dissolving it and allowing a doctor to manually straighten the affected digits. The injection does not need general or regional anaesthetic, but a local anaesthetic is applied for the manipulation.

The type of treatment you will receive will be decided after discussion with your consultant surgeon.

Surgical time varies according to complexity but usually lasts between 45 and 90 minutes. Recovery times for surgery can take between four and 12 weeks and for a Xiapex injection it is typically a fortnight. Both methods are carried out as day surgery, which means you will go home on the day of your procedure and you do not need to stay in hospital overnight.

Both surgery and injection have good results, although in some cases over time the procedure may need to be repeated. For Xiapex, 92% of patients in the UK who have had the procedure say they were ‘very satisfied’ or ‘quite satisfied’ with the results but the re-occurrence rate at five years is higher for injection compared to a surgical release.

Risks are minimal. Potential risks are those related to all types of surgery including infection, nerve and blood vessel injury. Risks specific to this surgery is stiffness and reoccurrence.

A pre-operative assessment is our opportunity to ensure that the procedure for which you have been referred is right for you. We’ll explain your treatment to you and makes sure that you are well enough to go ahead with it. It is also your opportunity to meet the team who will care for you and to ask any questions.

We carry out all the necessary tests and examinations in one outpatient session. While this may take several hours, everything is done in one go to save frequent visits before surgery.