What is a fasciectomy?

A fasciectomy (fash-ee-EK-tuh-mee) is surgery to remove some or all of the fascia, a fibrous layer of tissue in your hand, which contracts because of Dupuytren's disease. This can force one or more of your fingers into the palm of your hand; sometimes, you cannot straighten your fingers. After a fasciectomy, your fingers relax and improve your hand function.

What is Dupuytren's disease?

Dupuytren's disease is a chronic and progressive disorder of connective tissue. It makes the fascia that comprises both hands become thickened and tight. Your musculoskeletal system supports your muscles, organs, joints, and skin through connective tissues. Some people inherit a gene mutation from one parent that triggers Dupuytren's disease. There are others for whom the disease develops for no apparent cause.

For someone affected with Dupuytren's disease, nodules or small lumps of tissue develop in the fascia that supports the skin on the palm. These eventually thicken into cords of tissue. These cords pull one or more fingers (and, less often, your thumb) toward your palm. Your doctor may call this Dupuytren's contracture.

Who needs a fasciectomy?

The disease is chronic and progressive. Your provider will attempt nonsurgical treatments first. These might include steroid or collagenase (an enzyme) injections. Nevertheless, you may experience severely bent fingers that impair the functional ability of your hand. At this stage, your provider may discuss surgical alternatives such as a fasciectomy or a fasciotomy.

What is the difference between fasciectomy and fasciotomy?

The surgical interventions used in the treatment of Dupuytren's disease are:

• Fasciotomy: Your doctor cuts through the palm of your hand and divides the thickened cord of tissue. This division also weakens the tissue, allowing you to bend and move your fingers more appropriately.
• Percutaneous needle fasciotomy: This procedure is sometimes referred to as a needle aponeurotomy. The provider punctures the hardened tissue with a tiny needle, creating holes in the tissue. The small holes work to weaken and tear the affected tissue to the point where you can easily bend your fingers.
• Fasciectomy: In a fasciectomy, also known as palmar fasciectomy, the nodules and cords of tissue that pull on your thumb and fingers are removed.

Who performs a fasciectomy?

Fasciectomies usually are carried out by orthopedic hand surgeons. Orthopedic surgeons are subspecialists in the surgical treatment of musculoskeletal disorders. Hand surgeons are, therefore, orthopedic surgeons with further qualifications in the specialty area of hand surgery.

What should I know before a fasciectomy?

It would help if you observed your surgeon's recommendations regarding steps you can take before the procedure. You may be directed to:

• Do a pre-admission diet and fast before surgery.
• Quit smoking.
• Avoid taking certain medications, like vitamin preparations and herbal supplements.

What is the main difference between a partial fasciectomy and a total fasciectomy?

A partial or subtotal fasciectomy only removes the affected tissue. Total fasciectomy removes the entire fascia, even the healthy tissue. Your surgeon will explain the choices available to you and choose the most effective treatment suited to your circumstances.

What are the types of fasciectomies?

There are various ways in which a surgeon may perform a fasciectomy. The actual fasciectomy procedures include:

• Segmental (partial) fasciectomy: This is achieved by making small incisions at the very edges of your hand along the natural creases. Then, he separates the thickened tissue from the nearby tendons and nerves before removing a short section of the affected tissue cord.
• Subtotal palmar fasciectomy: Your surgeon will make several incisions --frequently zigzag along the lines of the palm and fingers--removing as much diseased tissue as possible. You will probably need a skin graft to help the wounds heal.
• Dermofasciectomy: This is the surgical treatment used for recurrent Dupuytren's contracture. It involves removing part of the disease-causing fascia tissue and some of the skin from your palm. A skin graft will be necessary.

What happens during a fasciectomy?

A segmental fasciectomy usually takes place as an outpatient. This means that you would leave the hospital on the same day. You may be given regional anesthesia that will numb your upper body. Your surgeon might then leave this small wound open to the air with no stitches, allowing it to drain and heal over time. A bandage is used to minimize the chance of infection.

Subtotal palmar fasciectomies and dermofasciectomies are longer and more complex procedures. Often, they require skin grafts. You may receive general anesthesia to sleep through the operation. Since there is an increased risk of infection with a graft, you may be required to spend the night in the hospital.

What are the advantages of a fasciectomy?

A fasciectomy may enable you to regain function in your hand, fingers, and thumb. Debridement of the diseased fascia enables you to flex and extend your digits. Certain studies suggest that you are more likely to obtain a good result than a fasciotomy or needle aponeurotomy with more enduring outcomes.

What are the potential complications of a fasciectomy?

Numbness or loss of feeling in your fingers is one of a fasciectomy's most common side effects. This condition will likely be temporary, especially as contracted nerves begin to stretch. In some cases, nearby nerves and blood vessels may be severed, making a finger unusable; you may have to undergo amputation.

Some potential complications of a fasciectomy include:

• Allergic reaction to anesthetic.
• Infections
• Irritation and scarring of the skin
• Bruising
• Swelling (edema).

What are the post-operative recovery experiences after a fasciectomy?

Expect some discomfort, swelling, and stiffness after surgery. Some patients have tingling or numbness in the hand or fingers; this condition is typically temporary and resolves within several months. Depending on your type of employment, you will likely be off work for two to 12 weeks.

Incision care and recovery as directed by your physician. This may include:

• Applying an ice pack and raising your hand.
• I cleaned the wound with soap and water and applied a bandage.
• You are keeping your hands and stitches dry when bathing.
• Following hand therapy and doing hand exercises at home.
• You are taking any prescribed medications, including antibiotics and pain management medications.
• She was wearing a splint for up to 12 weeks.

Does a fasciectomy cure Dupuytren's disease?

Surgery will not cure the underlying disease but can improve hand function. Most people will have some recurrence of Dupuytren's contracture after a fasciectomy. You may need another surgery.

When to call the doctor?

Call your health care provider if you have:

• Contact dermatitis with an itchy rash.
• Chest pain or shortness of breath.
• Loss of feelings or motion in your fingers.
• Severe muscle pain.
• The common signs of an infection include fever, yellowish discharge, or red streaks.

Why Tender Palm Super-Speciality Hospital for Dupuytren's contracture fasciectomy?

Tender Palm Hospital, owned by doctors, is renowned for attracting the most skilled professionals in the country. With the finest Orthopedic surgeons, specialized in Dupuytren's contracture fasciectomy. Tender Palm stands out as the premier orthopedic hospital in Lucknow, India. Boasting cutting-edge infrastructure and advanced technology, Tender Palm ensures top-notch medical care for its patients.

To seek an expert consultation for any orthopedic condition.

Call us at +91-9076972161
Email at care@tenderpalm.com

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