Dupuytren release is not one type of hand surgery
The term Dupuytren release refers to either of two types of hand surgery: fasciotomy or fasciectomy. Either of these can be provided to release the thickened and shortened contracture of the hand lump associated with Dupuytren’s disease, resulting in a temporary reduction or release of the tightening and flexion of one or more fingers.
When considering undergoing a Dupuytren release, remember that no release procedure offers a permanent correction; all are a temporary solution because recurrence of Dupuytren contracture will happen sooner or later, usually within three to five years or so.
Dupuytren surgery should be reserved for situations in which the hand contractures keep the involved finger(s) at 30° flexion, or when the individual has a positive tabletop test in which both the palm and fingers cannot be held flat against a tabletop.
A Dupuytren release involves making one or a series of incisions into the palm to remove the thick, contracted and inflamed soft tissue (fascia) that surrounds, supports, and separates the tendons and tendon sheaths of the fingers and hand, while preserving the uninvolved skin, arteries, veins and nerves, correcting joint deformities, and maintaining proper flexion and grip strength.
There are five different surgical methods that are termed a Dupuytren release:
- Partial or selective fasciectomy – most common Dupuytren release, during which one or more incisions are made across the palm, dependent upon the size, depth and location of the nodules, cords and contractures, as well as history of prior Dupuytren release surgeries and hand trauma, age and occupation. Recurrence somewhat more frequent than after other types of Dupuytren surgery.
- Subcutaneous fasciotomy – Less common Dupuytren surgery. Single or multiple incisions (usually in a zig-zag pattern) for widespread dissection over the contracted tissue, but diseased tissue is not removed. Recurrence is slightly more frequent than a regional fasiectomy.
- Complete fasciectomy – Rarely indicated because of frequent complications and frequency of recurrence. .
- Fasciectomy with skin grafting – Less common Dupuytren surgery. Surgical removal of diseased skin and fascia overlying Dupuytren cords, in which diseased soft tissue of palm replaced with a skin graft from patient’s forearm. Recurrence is somewhat less frequent than regional fasciectomy.
- Amputation – performed after failed Dupuytren release surgery or after multiple recurrences where no additional surgery is possible.
Dupuytren release not a cure
A Dupuytren release does not cure or eliminate the disease. When it works out well it will only temporarily modifies the progression of the disease and temporarily improves hand function. When it does not work out well it can result in a worse problem than before the release surgery. Recurrence is still likely after Dupuytren surgery
Since 2002 the Dupuytren Contracture Institute has maintained that an initially conservative approach to treatment is most prudent and defendable. If after following a moderate term course of intense non-invasive Alternative Medicine treatment of Dupuytren contracture there is a lack of sufficient response, then more radial invasive measures can always be explored.
The normal and full use of your hands can be taken from you as Dupuytren contracture progresses. There is an alternate way to do all that you can, as early as you can, to allow your body the best opportunity to naturally reverse this problem.
For ideas and suggestions to organize an effective Alternative Medicine treatment plan, to possibly avoid the need for Dupuytren release surgery, click natural Dupuytren Treatment Plan.
For more information about trying to avoid Dupuytren surgery: