Patient information Dupuytren s contracture i Important information for all patients. Golden Jubilee National Hospital Agamemnon Street Clydebank, G81 4DY (: 0141 951 5000 www.nhsgoldenjubilee.co.uk Last updated: July 2015 Due for review: July 2016 Version 5
About this booklet The purpose of this booklet is to provide you with some useful advice and general guidance on what to expect from your surgery for your. All information provided in this booklet is for guidance only and is not exhaustive. Detailed, individual instruction will be provided by your surgeon and physiotherapist. What is? is a thickening of the fibrous tissue beneath the skin on the palm of the hand. Over time this fibrous tissue forms a tight band between your palm and finger tendon. This band thickens and contracts, pulling your finger in towards your palm. It can gradually get worse, causing your finger to bend in more. If left untreated, it may become permanently bent in. More than one finger can be affected on either or both of your hands. is painless and often mild, which means that it may not cause significant problems. However, if the finger is severely contracted, it can make simple tasks difficult, such as buttoning up a shirt. 2
What causes? The exact cause is unknown but it occurs when cells (fibroblasts) reproduce more than usual. There are some factors which make you more likely to develop, such as: smoking; excessive amounts of alcohol; diabetes; family history; epilepsy; and hand injuries. If it is untreated, the contracture will continue to progress. This may be faster in younger patients and there is an increased chance of recurrence in younger people following surgery. How is diagnosed? If you think you have a and it is causing you problems, consult your GP. It can usually be diagnosed by examining you and asking questions about your symptoms. Surgery The aim of the surgery is to regain movement in your affected finger, allowing it to straighten. How straight your finger will be depends on the success of your surgery. Regaining this movement should make your hand more functional and make day-to-day activities easier. 3
Admission You will be brought in early in the morning for your surgery and discharged later in the day; sometimes an overnight stay may be required. You will be seen by the surgeon prior to surgery who will answer any concerns you may have and explain any procedures. The surgery will take about one to two hours. After surgery On return from theatre your hand will have a bulky bandage in place. Your arm will be raised on a pillow or in a sling; this will keep your hand elevated to help reduce swelling. The nursing staff will check your blood pressure and pulse. The circulation, movement and sensation to your fingers will be assessed regularly. You will be able to eat and drink once you have returned to the ward. The procedure is carried out under a local anaesthetic so there is no reason to remain on the ward unless the surgeon has requested to see you. The nursing staff will let you know when you can be discharged. Physiotherapy advice Physiotherapy is vital in regaining function of your hand. You will be given an appointment to return to the clinic five to nine days after surgery. At this appointment your dressing will be reduced by a nurse and reapplied. The physiotherapist will review your hand and will supply and fit a splint to help keep your fingers straight. Each consultant has a different approach to the surgery; therefore, the specific details regarding the use of your splint will be discussed by 4
your physiotherapist or consultant. The physiotherapist will also give you an exercise programme to begin moving your hand. You will be referred onto your local hospital or health centre for ongoing therapy. You will return to the clinic at around 10-14 days to have your stitches removed. Activities of daily living Your ability to complete basic tasks will be reduced when you first go home. If you usually rely on your operated hand, your ability to prepare meals and perform daily activities may be affected. You can do much to minimise this inconvenience by preparing before you come into hospital. For example, stock up on easy to prepare meals and make alternative arrangements for shopping and domestic tasks. If you have concerns about how you will manage at home the Occupational Therapist may be able to offer some practical advice. Discharge advice Your surgeon may request that you wear a sling. To prevent stiffness, this must be removed for five minutes every hour to exercise the elbow and shoulder joint. If there is any further swelling, increasing pain, numbness or any change in the colour to your fingers, you must contact the ward immediately on 0141 951 5000 extension 5282. Keep the dressing clean and dry as it will be left in place until you return to the clinic. You may require some simple painkillers like paracetamol and ibruprofen. If you do not have these at home please inform the nurse prior to discharge. You may be off work for up to two to four weeks depending on your type of employment, please discuss this with your consultant. It is also strongly advised that you do not drive until the wound has healed or until after the sutures are removed. 5
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(: 0141 951 5513 Please call the above number if you require this publication in an alternative format Golden Jubilee National Hospital Charity Number: SC045146 OR05