If other treatments haven’t provided enough relief, surgery may be recommended.
Each surgical approach is different. Your healthcare provider will make recommendations based on how the contracture affects your daily activities.
Generally, less involved procedures may mean a quicker recovery, but your symptoms might return sooner, says Claude Jarrett, MD, an orthopedic surgeon based in Wilmington, North Carolina, who specializes in upper extremity surgery.
More complex surgeries often need more recovery time, but the results may last longer, he adds.
Needle Aponeurotomy
One of the least invasive surgical options is needle aponeurotomy (or needle fasciotomy), which can be done in a medical office.
After numbing the area with a local anesthetic, a healthcare provider uses the tip of a needle to poke tiny holes in the tight cord beneath the skin.
This weakens the cord enough that your finger can be gently stretched back to a straighter position. This procedure can help improve finger movement, even in severe cases, with few side effects.
Fasciotomy
A fasciotomy is a minor surgery that involves making an incision in the palm to break up the tight cords.
You’ll typically receive a local anesthetic to numb your hand. While the cord isn’t removed in a fasciotomy, breaking it up helps decrease the contracture and improve finger movement.
This procedure works well for many people, though some may eventually need additional treatment.
Partial Palmar Fasciectomy
If contractures are severe, a partial palmar fasciectomy (removal of the fascia) may be recommended. This surgery involves removing portions of the cord through multiple incisions in the palm and affected finger or fingers.
Depending on the extent of the surgery, a skin graft, in which healthy skin from another part of your body is used to cover the wound, may be necessary to heal the wound.
Compared with00 a needle fasciotomy (aponeurotomy), this surgery requires more healing time, but it often provides longer-lasting results, with about 20 percent of people experiencing a return of their contracture.
Dermofasciectomy
If you have a more severe case of Dupuytren’s contracture or if the contractures return after previous treatments, you may need a dermofasciectomy (removal of fascia and skin).
In this procedure, the surgeon removes both the cord and the overlying skin from your palm and uses a skin graft to cover the area.
A dermofasciectomy can reduce the chance of the contracture coming back.
Some of the risks of this procedure include the skin graft not working well, scarring, and a higher chance of complications, including infection and chronic pain syndrome.
