Are your fingers curled inward and difficult to straighten? Let's talk about Fasciectomy surgery!

Have you ever felt like a finger or several fingers on your hand are slowly bending towards the palm? Does it feel very difficult to straighten it even when you try to straighten it? This could be a symptom of a condition called Dupuytren's disease. When this condition is severe, it can become impossible to straighten your fingers at all. So, today we are talking about Fasciectomy, a very effective treatment for this condition.

What is Fasciectomy?

Fasciectomy is simply a surgical procedure. It involves removing a layer of fibrous tissue called fascia from your hand. Think of it like a thin membrane under the skin of your hand. In someone with Dupuytren's disease, this membrane gradually thickens, tightens, and begins to contract. It then pulls the fingers in toward the palm.

So, what this Fasciectomy surgery does is remove that tight tissue and allow your fingers to straighten freely. This will help you regain the function of your hand.

What is Dupuytren's disease?

Dupuytren's disease is a progressive connective tissue disorder. What happens in this is that the fascia, which we mentioned earlier, in the hand or both hands becomes thick and tight. This connective tissue in our body is what connects our muscles, organs, joints, and skin together and acts as a support.

Some people may develop this disease due to a genetic mutation that is passed down through generations . However, some people may develop this condition without any apparent cause.

People with this condition first develop small nodules under the skin of their palms. Over time, these nodules join together and form thick, rope-like cords. These cords pull one or more fingers toward the palm. Doctors also call this condition Dupuytren's contracture .

Who really needs this surgery?

Because Dupuytren's is a progressive disease, your doctor will first try non-surgical treatments.

• Steroid injection
• Injection of the enzyme collagenase

If these treatments don't help, meaning your toes are so bent that you can't even do your daily activities, your doctor may suggest surgery. Fasciectomy is the most common surgery performed in such cases.

Fasciectomy, Fasciotomy... What's the difference?

There are several surgical treatments for Dupuytren's disease. They are slightly different from each other. Let's take a look at what they are. You can easily understand this difference by looking at this table.

What should you do before surgery?

It is very important to follow your surgeon's instructions carefully before surgery. They may usually ask you to do things like:

• Fasting (abstaining from eating and drinking) for several hours before surgery.
• If you smoke, stop . Smoking interferes with the healing process.
• You may be asked to temporarily stop taking certain medications, vitamins, and herbal supplements .

Are there different types of surgery?

Yes, there are different types and methods of fasciectomy surgery depending on the condition of the disease.

Difference between Partial and Total Fasciectomy

• Partial (partial removal): This involves removing only the diseased, thickened tissue.
• Total (complete removal):In this, the entire fascia membrane of the arm is removed, including healthy tissue.

Your doctor will decide and explain to you which method is best for you.

Surgical methods

• Segmental fasciectomy: In this procedure, several small incisions are made along the natural creases of the hand and only a small portion of the thickened fascia (cord) is removed.
• Subtotal palmar fasciectomy: Several incisions are made along the creases of the palm and fingers (often in a 'Z' shape) to remove as much diseased tissue as possible. Sometimes a skin graft may be used to help the wound heal.
• Dermofasciectomy: This is done in cases where the disease recurs. Here, the diseased fascia tissue is removed along with the overlying skin. In this case, a skin graft is necessarily performed.

What are the benefits of surgery?

The biggest benefit of this surgery is that you can regain function in your hand, fingers, and thumb. Once the tight tissue is removed, you can extend and straighten your fingers better. Some studies have shown that the results of fasciectomy surgery last longer than other treatments.

Are there risks and complications?

As with any surgery, there is a small chance of some risks and complications. But don't worry, these are very rare.

Other possible complications:

• Allergy to anesthesia
• Wound infection
• Skin sensitivity and scarring
• Bruises
• Swelling (edema)
• Very rarely, nerves or blood vessels in the hand may be damaged.

How is the recovery time?

It is normal to feel some pain, swelling, and stiffness in your hand after surgery. You may also feel numbness in your hand and fingers. It may take several months for these to completely go away. Depending on the nature of your job, you may need to take two to twelve weeks (about 3 months) off work.

It is very important to follow your doctor's instructions during your recovery.

• Place an ice pack on the arm, keeping it elevated.
• Clean the wound with soap and water and keep it covered with a bandage.
• Take care not to get your hands and stitches wet when bathing.
• Physical therapy treatmentAttending the sessions and doing the exercises at home exactly is essential to regaining hand function.
• Taking prescribed painkillers and antibiotics exactly as prescribed.
• You may be asked to wear a splint (a support that keeps your hand still) for about 3 months.

What time should I call the doctor?

If you experience any of the following symptoms after surgery, you should call your doctor immediately .

Dupuytren's disease can be a major obstacle to your daily activities and work. Fasciectomy surgery allows you to regain full use of your hands and fingers. The most important thing is to follow the correct physical therapy and exercises after surgery.