Fasciotomy

Your hands and wrists are essential tools that allow you to work, play and perform everyday activities. How well the hand and wrist interact depends on the integrity and function of the ligaments, tendons, muscles, joints and bones.

Problems in any of these can affect upper extremity function, causing disruptions at home and work and negatively impacting quality of life.

The human hand itself is very complex and delicate in structure.  At some time in life, you may experience hand or wrist pain.

Dupuytren’s contracture is a thickening of the fibrous tissue layer underneath the skin of the palm and fingers. Although painless, the thickening and tightening (contracture) of this fibrous tissue can cause the fingers to curl (flex).

There is no effective means by which the course of Dupuytren’s disease can be altered, so the early, nodular stages are usually a case of observation only. Patients are generally seen by a physician every few months to monitor the extent of the condition.

When Dupuytren’s causes finger contractures to form, then surgery is usually recommended. Contractures are easily noticeable since this tightening of the tissues cause the fingers to bend and remain in a fixed position.

Treatment

Surgical decisions are made based on the individual joint that is held in the contracted position. When a fist is made, there are three joints that are apparent in each finger. Any contracture of the middle joint is generally not tolerable and should be a candidate for surgery.

Commonly prescribed surgical procedures are called a fasciotomy or fasciectomy. This procedure removes segments of the diseased fascia, which helps increase the mobility of the fingers. It is important to consider early surgery with the onset of any contractures as significant delay may ultimately require a larger procedure.

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