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Dupuytren’s contracture is a fairly common disorder of the hands and fingers whereby the Palmar Fascia (tissue underneath the palm of your hand) becomes thickened contracting (shortening) one or more of your fingers. It most commonly affects your little or ring finger, sometimes both, and can occur in both hands. The tissue that lies between your finger tendons and the skin becomes thickened, contracting the tissue pulling your finger towards your palm. This condition progress slowly and is usually pain free with only a small number of people requiring surgery. However, surgery is indicted if the condition worsens and your hand is unable to function properly.


Hand and wrist mobilisations performed by a specialist PhysiotherapistAbove: Hand and wrist mobilisations performed by a specialist Physiotherapist



There are three surgical methods to treat Dupuytren’s Contracture:
  • Open Fasciotomy – the overlying skin is cut open and the contracture is cut.
  • Needle Fasciotomy – the contracture is cut using a needle inserted into the skin.
  • Open Fasciectomy – the overlying skin is cut open and the contracture removed.
The surgery is minimally invasive and optimal recovery is around six weeks. After your surgery Physio.co.uk will help to restore pain free hand function.


Symptoms after Dupuytren’s ContractureSurgery



Following dupuytren’s contracture surgery, your hand will be stitched and bandaged and your finger placed in a splint in order to support your hand and keep your fingers straight. Symptoms you may experience following surgery include:
  • Pain
  • Swelling
  • Weakness
  • Sensory impairments
Your physiotherapy programme with Physio.co.uk will begin immediately in order to restore hand function and prevent any re-contractures.


Hand mobilisation exercises performed by PhysiotherapistAbove: Hand mobilisation exercises performed by Physiotherapist



Physiotherapy afterDupuytren’s ContractureSurgery



Physio.co.uk will assess your hand during your first session and then design a personal rehabilitation programme specific to the symptoms and problems that you present with. Treatment will focus on restoration of functional hand and finger movements, strengthening and prevention of repeated contractures.Treatment can begin immediately following surgery and full recovery can be seen within six weeks.


Days 0-7



Initial physiotherapy with Physio.co.uk will resolve around careful wound monitoring and pain management. Your physiotherapist will assess your hand and then begin a course of therapy to reduce stiffness and increase range of movement in your hand and fingers. Your treatment will include:
  • Cryotherapy (Ice)
  • Pain reduction
  • Wrist range of movements exercises
  • Gentle stretches
  • Passive finger range of movement exercises
  • Gentle active finger range of movement exercises
  • Wound monitoring
  • Splint fitting

Week 1 -3



After one week of physiotherapy your programme with Physio.co.uk will focus on a continuation and progression of exercises to increase range of movement, release tight structures and develop strength in your fingers. Treatment will include:
  • Heat therapy
  • Increased finger range of movement exercises
  • Finger strengthening exercises
  • Soft tissue massage
  • Stretching
  • Grip strengthening

Weeks 4-6



Following week three, Physio.co.uk will intensify your treatment in order for you to regain fully functional hand movement:
  • Vigorous stretching
  • Soft tissue massage
  • Strengthening of fingers
  • Active range of movement exercises
  • Increased grip strengthening
  • Splint – may be worn for up to 6 months to prevent re-contractures
Following six weeks of physiotherapy with Physio.co.uk, you will have achieved a large improvement in range of movement and strength throughout your hand and fingers with a significant improvement of hand function. The goals of your physiotherapy programme will continue to focus on maximising the success of your surgery and preventing the likelihood of future problems.


Summary



Dupuytren’s Contracture is a common disorder that causes the palmar fascia to become tight resulting in one or more fingers being fixed into a flexed position. It affects more men than women and usually affects people aged 40 or over. This condition can result in disabling hand function and in order to prevent this surgery is required to release this tightness. Following surgery, a comprehensive physiotherapy programme through Physio.co.uk is crucial to ensure success of the operation, guarantee the return of full function and prevent any future problems occurring. Physio.co.uk will help to reduce post surgical complications and restore full hand and finger function helping you achieve a rapid and full return to your daily activities and hobbies. Call Physio.co.uk now on 0330 088 7800 for more information or to book an appointment please contact us.


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