Dupuytren's contracture - Recovering from surgery for Dupuytren’s contracture

Recovering full or partial function of the hand following hand surgery for Dupuytren’s contracture can take a long time. Generally, the more extensive your surgery, the longer your recovery time.

It's important to discuss your recovery and any aftercare procedures that you may need with your specialist before having surgery.

Hand therapy

After surgery, you may need specialised hand therapy to help improve the function and range of movement of your hand. For example, you may need to have:

• physiotherapy – this could involve a number of techniques to help improve your range of movement, including massage, manipulation, exercise, electrotherapy and hydrotherapy
• occupational therapy – if you are struggling with everyday tasks and activities, either at work or at home, an occupational therapist will be able to provide you with practical support to make those tasks easier

How long you will need to have treatment or assistance for will depend on the type of surgery you have had. For example, you may need hand therapy for up to six months after more extensive procedures.

Splinting

Splinting usually involves bandaging your fingers to a plastic strip while they are in the straightest position you find comfortable. Splinting may initially be recommended all day before being used only at night, and then not at all.

Splinting is not currently a standard procedure and some specialists prefer not to use splints. When splints are used, there is often wide variation in the length of time they are used for, the position of the fingers and how much force is used to keep the fingers straight.

Some specialists believe that splints can positively influence the way that scar tissue forms after surgery, so that the scar doesn't contract and cause the condition to return. Others believe that splints can cause unnecessary pain, joint stiffness and swelling (oedema), so prefer not to use them.

Several research studies have been carried out to try to determine whether or not using splints is effective in the recovery of Dupuytren’s contracture.

One study found that there was no difference between the range of hand movement experienced by a group of people who were routinely splinted after having types of surgery called a fasciectomy or a dermofasciectomy and a group who received hand therapy and were only splinted if contractures occurred.

Driving

After having hand surgery, you can start driving as soon as you feel confident enough to control the car safely. This will usually be after about three weeks, but it may be longer if you have had a skin graft.

Work and sport

When you will be able to return to work will depend on the nature of your job and the type of operation you have had.

If you do heavy manual work, you may not be able to return to work for six weeks after having a skin graft. If you work in an office, you may be able to return to light duties a few days after having a fasciotomy. The same advice applies to sport.

Recurrence

Surgery can help improve hand function in people affected by contractures, but it does not stop the process that caused the contracture to develop in the first place. Therefore, there is a chance the condition may return in the same place or it may reappear somewhere else after treatment.

Recurrence is more likely to occur in younger people, people who had a severe contracture and people with a strong family history of the condition.

The chances of the condition returning after surgery also depend on the specific procedure you had. Dupuytren's contracture recurs in more than half of people who have a type of minor procedure called a needle fasciotomy, but only about one in three people who have a fasciectomy. A dermofasciectomy is associated with the lowest risk of recurrence, with the condition reappearing in less than one in 10 people after the procedure.

The experience of the surgeon who carries out the procedure may also influence the chance of recurrence.