Let's learn about the surgery (Fasciectomy) for the disease that causes the fingers to bend inward?

Have you ever felt like one or more of your fingers are gradually bent inward and becoming difficult to straighten? It feels like your finger is being pulled inward and stuck, doesn't it? This is what we call Dupuytren's disease. This condition can make it difficult to even do everyday tasks. Today we're talking about a special surgery that is performed as a solution to this condition, called a Fasciectomy.

First of all, what is Fasciectomy?

Simply put, a fasciectomy is a surgical procedure that removes a layer of tissue (called fascia) that has become tight and thickened on the inside of your hand due to Dupuytren's disease. This condition causes one or more of your fingers to bend involuntarily toward the side of your hand. In some severe cases, your fingers may become unable to straighten at all. So, after this fasciectomy, the tight tissue is removed, freeing your fingers and allowing you to regain normal function in your hand.

What exactly is Dupuytren's disease?

Dupuytren's disease is a connective tissue disease that gradually worsens over time. Now you may be wondering what connective tissue is. It is a type of tissue that connects and supports all of the muscles, organs, joints, and skin in our body.

This condition is caused by the thickening and tightening of the fascia, a layer of tissue under the skin of the palm. Some people may inherit this condition from their parents through a gene mutation . Others may develop the condition for no apparent reason.

As the disease begins, small nodules appear under the skin of the palm. Over time, these nodules join together to form tight cords . These cords then begin to contract, causing the fingers attached to them to pull inward. Doctors also call this condition Dupuytren's contracture .

Who needs fasciectomy surgery?

Because this is a progressive disease, your doctor will first try non-surgical treatments, such as steroid injections or injections containing an enzyme called collagenase.

What is the difference between Fasciectomy and Fasciotomy?

There are several surgical treatments for Dupuytren's disease. Let's briefly understand the main differences between them.

Main types of fasciectomy surgery

There are several ways to perform a fasciectomy. Your doctor will choose the most appropriate method based on your condition.

• Segmental (partial) 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 is removed.
• Subtotal palmar fasciectomy: A zigzag incision is made along the creases of the palm and fingers, removing as much diseased tissue as possible. In this case, a skin graft may be used to help the wound heal.
• Dermofasciectomy: This is done in cases of recurrent disease. In this, the diseased tissue is removed along with the overlying skin. This usually requires a skin graft.

How is the recovery time after surgery?

It is normal to experience some pain, swelling, and stiffness in your hand after surgery. You may also feel numbness in your hand and fingers. This numbness is felt as the nerves that have been stretched for so long return to normal, and it may take several months to go away. Depending on the nature of your work, you may need to rest for two to twelve weeks (3 months).

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

• Keeping your hand elevated and applying ice.
• Keeping the wound clean.
• Keep the wound and stitches dry, without touching them with water.
• Be sure to attend physical therapy and do the exercises given at home exactly.
• Proper use of painkillers and, if necessary, antibiotics.
• Wearing a splint on your hand for as long as the doctor tells you.

Are there any risks to the surgery?

As with any surgery, there are some risks. It is normal to experience some loss of sensation or numbness in the fingers, which will improve over time. However, there are some serious risks that can occur very rarely .

• Allergy to anesthesia.
• Infection.
• Scars and skin hypersensitivity at the site of surgery.
• Swelling (edema) and bruising.
• Very rarely, damage to nerves or blood vessels near the surgical area may occur.

When to seek immediate medical advice

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

• Signs of infection (such as fever, yellow fluid draining from the wound, red streaks).
• Severe muscle pain.
• Loss of feeling or inability to move the fingers.
• If you experience chest pain or difficulty breathing, go to the nearest hospital's Emergency Department (ETU) immediately.
• Skin allergies (e.g., itchy rash).

Fasciectomy, Dupuytren's disease, Dupuytren's contracture, Fasciotomy, Surgery, Hand surgery, Finger flexion, Bones and joints, Physiotherapy