Dupuytrens Disease / Fasciectomy
Dupuytrens Disease can affect a single digit or multiple. Often multiple procedures are required and as the disease is not curable, there is more than one procedure on the same finger. It is important to take into consideration the function of the whole and the patients’ expectations before undertaking surgery.
Post op rehabilitation therapy regime:
- Measure ROM in digits pre op for record
- Aims: Early movement of digits plus night extension splint
Some cases will remain in hospital over night unless they live locally and are able to attend as out patient with in a few days.
Immediate Post-op:
- Volar based POP or bulky dressing supporting fingers and wound in extension
- Elevation
- Neurovascular observations
- Analgesia
Day 1/2/3 :
- Reduction of post –op dressing
- Drain removed if present
- Wound inspection
- Review sensation
- Lightweight dressing to allow movement of digits
- Commence active flexion /extension of digits
- Provision of extension splint for night use
Day 7:
- Dressing changed
- Wound inspection
- Review ROM
- Review night splint
- Review sensation
Day 14:
- Wound inspection
- ROS
- Review ROM
- Review night splintv
- Commence scar care
- Review function
Weeks 2-6:
- Active /passive ROM to increase digital flexion and extension at MCP/PIP/DIP joints
- Continue scar care
- Extension and/or flexion splints as necessary
- Continue night extension splint
- Increase function
- Review sensation
- Discharge as appropriate
Weeks 6-12:
- As weeks 2-6 for those patients who have stiffness and/or poor extension
6 Month:
- Discard night extension splint
Changes in the Regime:
DERMOFASCIECTOMY: Post-operative management
Post-operative dressing and POP remain undisturbed for 5/10 days as dictated by Surgeon and then proceed as a fasciectomy.
FASCIOTOMY: Percutaneous needle or mini open
Patients will not require a resting splint through the day, but a resting night splint is recommended for at least 3 months.
