Dupuytren's contracture

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Approximate price

AED 2,090 - 5,225CAD 780 - 1,950CHF 560 - 1,400DKK 3,730 - 9,325EUR 500 - 1,250GBP 450 - 1,125SEK 5,160 - 12,900USD 570 - 1,425

Additional Information

This syndrome is manifested by the subcutaneous firmness on the palm in the form of a hard nodule or band, stretching from the palm to the fingers, bringing them to a contracted position. The fingers contracted in this way can not be voluntarily extended. The process originates from the palmar fascia. The skin covering the firmness can be fixed to it, therefore becoming elevated and uneven. The firmness never adheres to the blood vessels, nerves or tendons. The cause of this disease is unknown. It most commonly occurs in males over 50. Although there is some genetic predisposition to the disease, it is most typically found in epileptics, diabetics, alcohol addicts, and patients with chronic diseases. It more rarely occurs in females. The appearance of the disease is not related to the patient’s profession or the degree of manual activity. In approximately half of all cases, it affects both hands. The contracture may hit only one finger, most often the ring or little finger, but in some cases it may extend to several fingers.

Operation is indicated in the cases of advanced finger contractures, which disturb everyday activities. The progression of the disease is unpredictable. If it occurs at an early age, the disease shows a more invasive course and liability to recurrence after the operation. If the disease lasts for a long time, the fingers may get firmly bent toward the palm, which results in scar changes on the fingertips. Such changes may significantly compromise the postoperative results. Before the operation, it is necessary to check the patient’s general health status and do laboratory analyses.

The surgery is done in partial or total anesthesia and lasts between one and two hours. Fasciectomy is the surgical technique that gives the best results. Approached through ordinary incisions in the skin, the firm fascia is carefully removed, while blood vessels and nerves remain intact. By the removal of the fascia, the contracture is released and fingers extended. The drain should be placed before closing the incision. The hand is softly wrapped by elastic compresses.

Hospitalization need not last longer than one day. The drain is usually removed after the first day, and sutures after ten days. Activation of the fingers is advised as early as on the third day following the operation. Return to work depends on the postoperative course and the patient’s profession, and may be expected after one month. Functional results after the operation are generally good and last for years. Postoperative complications involve formation of haematomas, slow wound healing, prolonged numbness of the fingers and changes in sensation.

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