Information for patients with Dupuytren's Disease.
Edited By: Thomas Trumble, M.D.
Last updated Wednesday, January 12, 2005
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Management and treatmentPhysical therapy After surgery for Dupuytren's disease hand therapy is important in order to maximize the benefits of the operation. Patients should be referred to and followed by a hand therapist who will instruct them in exercises to be done in the post-operative period. Special splints may also be used, and may change as the time from surgery increases. Stitches are usually removed approximately 2 weeks after surgery. Some incisions may be left open to allow drainage. These will heal in on their own with daily dressing changes performed by the patient at home.Rehabilitation options Rehabilitation after surgery for Dupuytren's contracture consists of
hand exercises and splinting. Generally, the patient is referred to a
hand therapist to guide them in this process. The exercises are
designed to work on improved extension of the affected fingers through
active finger motion and stretching. Splints are often used at night to
hold the fingers in an extended position. These interventions are aimed
at maintaining the improved finger motion obtained in surgery, and
lessening recurrence of contractures.Can rehabilitation be done at home? Yes. The hand therapist is there to guide patients in their
postoperative hand therapy, but it is up to the patient to do most of
the work! It is important to have a good relationship with the hand
therapist, and to ask a lot of questions so that the reasons for doing
hand exercises, and using splints are clearly understood.Usual response Hand therapy after fasciectomy for Dupuytren's disease usually allows
the patient to maintain most of the improved finger motion obtained at
surgery. With time, however, approximately 50% of patients will have
some amount of contracture recurrence.Risks There are no significant risks to hand therapy after surgery for
Dupuytren's disease. Sometimes hand exercises will cause an incision in
the hand to partially open up, or may delay healing in an already open
incision. This is not a significant concern, and these areas will heal
in on their own with daily dressing changes.Duration of rehabilitation Rehabilitation usually continues for several weeks after surgery, and
the use of night splints may continue for even longer. As long as the
patient is receiving benefit from therapy, the therapist will usually
elect to continue following the patient. Although frequent visits with
a therapist may not be necessary, since patients can do most of their
therapy on their own at home, it is important to continue to be
followed by a hand therapist until he/she feels that therapy is no
longer necessary.Returning to ordinary daily activities Patients are encouraged to use their hand early in the postoperative
period. In general, after the sutures have been removed (usually 2
weeks after surgery), patients can return to most activities. If some
incisions have been left open, the presence of dressings may interfere
with daily work or recreational activities until the wounds have healed.Long-term patient limitations Once patients have recovered and the period of rehabilitation is over,
there are no restrictions placed on the patient in terms of activities
they can or can't do. Surgery for Dupuytren's Disease at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-BONE (2663) to make an appointment. Our clinical center is located in Seattle Washington, USA
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