# Dupuytren's Contracture (Fasciectomy)

> Surgical treatment for abnormal thickening and tightening of connective tissue in the **palm and fingers**

- Canonical page: https://doctormaresky.co.za/procedure/dupuytrens-contracture
- Category: [Hand Surgery](https://doctormaresky.co.za/procedure-category/hand-surgery)
- Procedure directory: https://doctormaresky.co.za/procedures.md
- Medical disclaimer: https://doctormaresky.co.za/medical-disclaimer


## Overview

**Dupuytren's Contracture** is an abnormal thickening and tightening of the connective tissue beneath the skin of the palm and fingers. In most cases, this is a painless deformity and can successfully be treated with non-surgical procedures.

## The procedure

There are certain non-surgical treatments that are recommended in the early stages of Dupuytren's. These include stretching, steroid injections and enzyme injections. If the non-surgical procedures are unsuccessful, there are two surgery options available: **open surgery** and **needle aponeurotomy**.

## Preparation

- **Timeline:** **1-2 weeks** before surgery

### Medical tests

- **Blood work** if indicated
- **ECG** if over 50 or with cardiac history
- Medical clearance for chronic conditions

### Medications

#### Medications to discuss stopping

- **Stop** aspirin and blood thinners **1-2 weeks** prior (with cardiologist approval if applicable)
- **Stop** NSAIDs (ibuprofen) **1 week** prior
- **Stop** herbal supplements **1 week** prior

#### Medications to continue

- **Continue** essential medications as advised by **Dr Maresky**
- Diabetics: discuss glucose management during surgery

### Lifestyle

- **Smoking:** **Quit** smoking at least **3 weeks** before surgery - critical for hand wound healing

- **Alcohol:** **Avoid** alcohol **48 hours** before surgery

- **Fasting:** No food or drink after midnight the night before surgery

### Arrangements

- **Arrange** transportation - you cannot drive with hand bandaged
- **Arrange** help at home for **3-7 days** (difficulty with daily tasks)
- **Prepare** one-handed meal options and setup
- **Set up** sleeping area with hand elevation pillows
- **Complete** work tasks requiring two hands before surgery
- **Arrange** time off work (**1-4 weeks** depending on job)

## Recovery and aftercare

You are likely to feel relief from your symptoms soon after your surgery, and the recovery time is generally very quick depending on the procedure chosen and the size of the incision.

## Expected results

Most patients experience significant improvement in finger movement and hand function. The success rate is high when performed by experienced surgeons.

## Frequently asked questions

### What causes Dupuytren's contracture?

The exact cause is unknown, but it's believed to involve genetic factors, age, gender (more common in men), and certain medical conditions like diabetes.

### Can Dupuytren's contracture recur after surgery?

While surgery is generally successful, there is a possibility of recurrence, especially in younger patients or those with aggressive disease.

### What is needle aponeurotomy?

This is a minimally invasive procedure where a needle is used to divide the contracted tissue, often performed in the doctor's office under local anesthesia.

### What causes Dupuytren's contracture?

The exact cause is unknown, but risk factors include Northern European ancestry, family history, age over 50, male gender, diabetes, smoking, and alcohol use. It's caused by abnormal collagen formation in the palm's connective tissue.

### How do I know if I need surgery for Dupuytren's contracture?

Surgery is typically recommended when finger contracture interferes with daily activities, you cannot place your hand flat on a table (tabletop test), or contracture exceeds **30 degrees**. Early intervention often leads to better outcomes.

### What is the recovery time after Dupuytren's surgery?

Initial healing takes **2-3 weeks**. Hand therapy usually begins within a few days post-surgery. Most patients regain functional use within **4-6 weeks**, though full recovery can take **3-6 months** depending on severity.

### Will my fingers be completely straight after surgery?

Results depend on the severity and duration of contracture. Mild to moderate cases often achieve near-complete straightening. Severe or long-standing contractures may have some residual contracture, but function is significantly improved.

### Can Dupuytren's contracture recur after surgery?

Recurrence can occur in **10-30%** of cases over **5-10 years**, particularly in younger patients or those with aggressive disease. However, surgery significantly improves hand function and quality of life even if some recurrence occurs.

## Indicative pricing

- Estimate: R60,000 to R90,000 ZAR
- Cost factor: Number of digits affected
- Cost factor: Severity
- Cost factor: Surgical approach
- Detailed cost page: https://doctormaresky.co.za/cost/dupuytrens-contracture
- Final pricing is confirmed after an individual consultation.

## Consultation and contact

- Consultation: https://doctormaresky.co.za/procedure/general-consultation
- Contact: https://doctormaresky.co.za/contact