Dupuytren's | Dr Oscar Brumby-Rendell

Dupuytren's Fasciectomy

Expert Care for Finger Contractures by Orthopaedic Hand Surgeon Dr Oscar Brumby-Rendell

Dupuytren’s (pronounced du-pwe-tranz) Contracture is a progressive hand condition that causes the fingers, typically the ring and little fingers, to bend permanently towards the palm. This condition results from abnormal thickening of the palmar fascia, making it difficult or impossible to fully straighten the affected fingers.

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Symptoms of Dupuytren's contracture

Living with a locked up finger

Individuals with Dupuytren's contracture find it challenging to perform normal activities, and their working capacity is often reduced.

Changing clothes, gripping objects, typing and shaking hands may become difficult. As this disease rarely affects the index finger and thumb, various activities (including writing and driving) are still within an individual's abilities.

This condition is progressive and generally is not associated with any pain.

Symptoms vary depending on how far the disease has progressed.

Initially, Dupuytren's contracture is marked by the palm's skin thickening and over time, the skin may become dimpled or puckered. The skin may become sensitive (not painful) due to nodules or lumps developing under the skin.

Tissue cords may extend from under the palm's skin to the fingers in later Dupuytren's stages, resulting in the fingers moving inwards. This disease can occur in either a singular or both hands. However, if it is the latter, one hand generally has a more severe condition.

Causes of Dupuytren's contracture

The causes of this disease are largely unknown. Medical research does not suggest that this disease is caused by overuse or hand trauma. This is contrary to many other hand and wrist conditions, such as carpal tunnel syndrome.

However, numerous factors are thought to increase the risk of developing Dupuytren's contracture, including:

Genetics – family history increases likelihood
Age – most common in people over 50
Gender – men are more frequently affected than women
Ancestry – higher prevalence in people of Northern European descent
Lifestyle factors – smoking and alcohol use
Medical conditions – such as diabetes or epilepsy
Previous hand trauma may also contribute

Dr Oscar Brumby-Rendell | ASULC | Adelaide Shoulder & Upper Limb Clinic | Elbow Surgery

Diagnosis

Dr Brumby-Rendell can diagnose Dupuytren’s Contracture through:

Detailed medical history
Physical examination of the hand
A simple “tabletop test” (placing the hand flat on a surface) to assess contracture severity

In most cases, imaging or blood tests are not required for diagnosis.

When to Seek Treatment

You should consider treatment for Dupuytren’s Contracture when:

Your finger can no longer fully straighten
You have difficulty performing daily activities
The condition is worsening over time
You’re experiencing reduced grip strength or hand coordination

Early surgical intervention may prevent worsening deformity and loss of function.

Treatment options for Dupuytren's contracture

Non-surgical measures can be implemented for many cases of this condition.

In some mild or early-stage cases, non-surgical treatments may help. These include:

Hand therapy and stretching
Collagenase injections (enzymatic fasciotomy – not widely available in Australia)
Monitoring of contracture progression

However, these options often provide temporary relief, and surgery is the definitive treatment for moderate to severe cases.

Surgical Treatment: Finger Release Surgery

Dr Brumby-Rendell performs individualised surgical procedures tailored to the severity of the condition. The most common options include:

Limited Fasciectomy

Removal of the thickened cords and affected tissue
Allows the fingers to return to a straighter position
Often performed as a day surgery under regional or general anaesthetic

Needle Aponeurotomy (Minimally Invasive Option)

Small punctures are made to divide the cords
Quicker recovery but higher recurrence risk
Suitable for less advanced cases

Surgery is highly effective at improving finger mobility, function, and quality of life. Dr Brumby-Rendell uses modern techniques and precision-based care to reduce the risk of complications and recurrence.

Frequently Asked Questions

When should I consider Dupuytren’s fasciectomy?

Surgery is typically considered when non-surgical treatments fail to provide relief and the contracture significantly impacts daily activities, limiting hand function.

How effective is Dupuytren’s fasciectomy in treating Dupuytren’s contracture?

Dupuytren’s fasciectomy is highly effective in releasing contractures and restoring hand function. However, there is a possibility of recurrence, and ongoing monitoring may be necessary.

How long is the recovery period after Dupuytren’s fasciectomy?

Recovery varies, but most patients see significant improvement within a few weeks. Full recovery, including returning to normal activities, may take several months. Physical therapy is crucial for optimal recovery.

Are there any risks associated with Dupuytren’s fasciectomy?

As with any surgical procedure, there are risks, including infection, nerve damage, and recurrence of the contracture. Dr Brumby-Rendell takes every precaution to minimise these risks and ensure a successful outcome.

Why Choose Dr Oscar Brumby-Rendell?

Qualifications and Experience: Dr Oscar Brumby-Rendell is an Adelaide orthopaedic surgeon with extensive training and experience in treating upper limb conditions.
Patient-Centred Approach: Dr Brumby-Rendell prioritises your needs with a compassionate, patient-centred approach, providing clear explanations and personalised treatment plans.
Values: Driven by commitment, passion, and integrity, Dr Brumby-Rendell is dedicated to achieving the best outcomes and maintaining the highest standards of care.