Dupuytren disease

What is Dupuytren disease?

Dupuytren disease, also known as Dupuytren’s contracture, is a condition that causes the tissue under the skin of the palm and fingers to thicken and tighten, potentially resulting in cords that can pull the digits or palm into a bent position.

Dupuytren disease will usually start as a small lump in the palm, which may eventually develop into a thick cord that can extend up to the fingers, causing them to bend or curl towards the palm. The condition most often affects the ring finger and little finger, but it can also affect other fingers, and it can affect one or both hands.

The cause of Dupuytren disease is largely unknown, but there is increasing evidence that it is due to your genetics, or DNA. It is more common in men, people over forty years of age, and in people of European descent.

Do I need Dupuytren disease treatment?

Dupuytren disease can affect people differently, and not everyone will need treatment.

Mild Dupuytren disease can cause lumps in your palm, or make your fingers or thumbs only slightly bent. Mild symptoms like this are unlikely to need treatment. One way to see if you need treatment is the ‘tabletop test’: if you can place your hand flat on the table then it’s unlikely your contracture will currently need surgery.
More severe Dupuytren disease can result in more severely bent fingers or thumbs, making it more difficult to complete some tasks. Patients more severe symptoms may benefit from some form of treatment to improve their function – using the ‘tabletop test’ above, these patients are usually unable to place their hands flat on a table.

If you are unsure if you need treatment, then a consultation with Dr Colbert is your first step. Dr Colbert will assess your Dupuytren disease, and if you need treatment then he’ll discuss the different risks and benefits of each treatment option during your consultation.

What does Dupuytren surgery involve?

Dr Colbert regularly performs sees and treats people with Dupuytren disease. While every Dupuytren contracture and every Dupuytren surgery is different, in general the affected tissue is excised to allow the affected finger to straighten (known as a fasciectomy). The steps involved in a fasciectomy:

Anaesthesia: usually sedation or general anaesthesia is used.
Incision: Dr Colbert will make an incision in your hand over the affected area, exposing the thickened tissue.
Dissection: Dr Colbert carefully dissects the thickened tissue away from the underlying structures, such as the tendons, nerves, and blood vessels.
Excision: The affected tissue is then removed, including any nodules or cords that have formed.
Haemostasis: Dr Colbert ensures the bleeding is controlled and the wound is clean and dry.
Closure and dressing: Dr Colbert then closes the wound with sutures, a sterile dressing is applied, and your hand is placed in a bandage.
Postoperative care: you will be discharged with pain medications, and asked to keep your hand clean and dry until follow up with Dr Colbert.

What is the recovery after Dupuytren disease surgery?

The recovery after Dupuytren disease surgery will depend on several factors, including the extent of your surgery, your overall health, and how well you can follow postoperative instructions. Here are some general guidelines for recovery after Dupuytren disease surgery with Dr Colbert:

Dressing care: you will be asked to keep your dressing clean and dry until follow up with Dr Colbert.
Pain management: you will be giving pain medication and anti-inflammatories to help manage any post-operative discomfort.
Hand elevation: Keeping your hand elevated will help reduce swelling and promote healing.
Hand therapy: hand therapy exercises may be used to help improve your hand range of motion and prevent stiffness.
Follow-up appointments: Dr Colbert will see you at two weeks to remove your sutures, change your dressing, and monitor your progress.
Returning to normal activities: you will be able to gradually reintroduce activities within your limits of pain over the several weeks after surgery.

What are the risks of Dupuytren disease surgery?

Dupuytren disease surgery is associated with the following risks:

Infection: Dupuytren surgery carries a small risk of infection, which can cause redness, swelling, pain, and fever.
Bleeding and bruising: Bleeding can occur during or after surgery, and may require further additional treatment.
Nerve damage: Surgery can damage the nerves in the hand, which can cause numbness, tingling, or weakness in the affected hand or fingers.
Stiffness: After surgery, some patients may experience stiffness in their hand or fingers, which may require hand therapy to improve.
Recurrence: In some cases, Dupuytren disease may recur after surgery, requiring further treatment.
Scar formation: The incision site may result in scarring, which can be painful or limit hand function.
Complex regional pain syndrome (CRPS): CRPS is a rare but serious condition that can occur after surgery, causing severe pain and swelling in the affected limb.
Anaesthesia complications: General anaesthesia or sedation can carry some risks, such as allergic reactions or respiratory problems.

Dupuytren disease surgery, like any surgical procedure, carries risks and therefore before proceeding you should always seek an opinion from an appropriately qualified health practitioner.

How much does Dupuytren disease surgery cost?

Costs associated with plastic surgery and Dupuytren disease surgery in Perth can be confusing.

To help make things clearer we have listed the following fees that make up the final cost of carpal tunnel surgery treatment.

Surgical fee: the costs of Dupuytren contracture surgery are mostly paid for by Medicare and your private health fund. Depending on the nature of your operation there will be some out of pocket expenses, sometimes known as a ‘gap’. Dr Colbert will discuss these costs with you during your consultation.
Anaesthetic fee: if you have your Dupuytren contracture surgery under sedation or general anaesthesia, then the costs of anaesthesia are mostly paid for by Medicare and your private health fund. Depending on the nature of your operation there may be some out of pocket expenses.
Hospital fee (this includes operation room fee, bed costs, surgical or medication fees, and any other hospital extras): Medicare does not cover this fee. If you have private health insurance then this may be covered by your insurance fund, but you should check with your fund if there is any out of pocket expenses. If you have no private insurance then you will have to pay this fee on discharge from the hospital.

Why should I see Dr Colbert for Dupuytren disease surgery?

Dr Colbert is a Specialist Plastic Surgeon with an interest in Dupuytren disease surgery. He has undergone extensive training to become a Fellow of the Royal Australian College of Surgeons (FRACS) in Plastic Surgery.

Once becoming a Plastic Surgeon he then underwent further training at Oxford University Hospital, including a hand fellowship at Churchill Hospital.

Meet Dr Colbert

Where can I find out more?

To arrange to speak to Dr Colbert about carpal tunnel surgery please contact our friendly office staff.

Alternatively you can leave a message by filling out our contact form.