Palmar fasciectomy is surgery to the hand to treat the effects of Dupuytren's contracture (or Dupuytren's disease). Surgery corrects the local thickening of the skin in the palm of the hand or on a finger. It also corrects the fingers that have been pulled towards the palm of the hand. Sometimes both hands need to be treated.
After the surgery the finger(s) will be straighter, but daily exercises may be needed to maintain the benefits of the surgery. Occasionally patients may also need to wear a splint for some time after surgery
A palmar fasciectomy involves the surgical removal of the thickened tissue which connects the hand and fingers. The operation may be carried out under a general anaesthetic (so you’ll be asleep during surgery) or a local anaesthetic (so you won’t be able to feel any pain).
Depending on the severity of the condition, the procedure can be carried out in one of three different ways:
- segmental fasciectomy – one or more small incisions are made in order to remove small segments of connective tissue
- regional fasciectomy – a single, larger incision is made though which all the affected tissue is removed. This is the most commonly used procedure.
- dermofasciectomy – the affected connective tissue is removed together with the overlying skin and the wound is covered with a skin graft (from another part of your body). This procedure will be used if the skin is also affected by the disease.
You may have some pain or discomfort after the operation which we’ll help you manage with painkillers. You may need to take some time off work.
We’ll tell you how to care for your wound and, if you’ve had non-dissolvable stitches, we’ll make an appointment for you to have them removed. The scar may be tender for several weeks. You may be recommended some hand therapy to help you recover full movement in your finger. This may involve physiotherapy or occupational therapy.
As with any surgical procedure there is some risk of infection of the wound, or bleeding after the operation. Because the nerves of the finger may be embedded in the contracted tissue there is a risk of temporary, or even permanent, numbness in part of the finger.
It is not uncommon for the contracture to re-develop after surgery, either in the same place or a new location. Sometimes repeated surgery may be needed to fully straighten the finger.
A cortisone injection into the cord or a nodule/lump can sometimes relieve some tenderness.