Following operative release for Dupuytren's contracture it is not uncommon to experience; swelling, scars, stiffness and some pain in the operated hand.
Most surgical techniques for Dupuytren's Disease involve many precise surgical incisions to remove the diseased tissues. With this amount of work in the palm and fingers, it is not surprising the hand can be uncomfortable to move and use afterwards.
To get the best results from your operation, following these simple steps should help;
For the first 10-14 days following the operation most people will have stitches holding their skin together. Disrupting wounds early can result in infection, excess scaring and skin breakdown.
During this time, unless advised by your surgeon or hand therapist, it is best to keep your hand rested and dressings clean and dry.
For the swelling
To help bring down the swelling, try elevating your operated hand. It may also help to gently raising your heart rate (walking around the room lifting knees up) whilst raising your arm.
Your hand therapist may recommend a gentle form of pressure over the hand and fingers to help manage swelling, for example a lycra glove or compression bandage.
For some people, medications and the operative technique may direct how swelling is to be managed, it's best to ask your surgeon whether you have any special precautions.
Safe early movement under the direction and observation of the hand surgeon or therapist can help prevent finger joint stiffness. In the early stages try to regain bending and straightening with your own muscle power. Depending upon your operation, using your other hand to straighten the operated or adjacent fingers or thumb may not be advised.
Gentle night extension splinting can be used to help stretch out any tightness in the joints.
Once the wounds are dry and clean and the skin is held together, scar massage can start. Keeping the scars in the palm of the hand and fingers supple is essential to getting the best bending and straightening. Early gentle massage with oily cream over the scars and surrounding skin is often combined with the use of a custom made extension night splint. Your hand therapist may also recommend a compression glove and special silicon gel products to help flatten and smooth the scar.
Using the hand
Depending upon the climate where you live, your work and hobbies, there may be some activities that are best avoided for the first month to 6 weeks. An experienced hand therapist will be able to discuss with you your individual goals, and make suggestions to help get you back to your valued activities as safely and quickly as possible.
Please note; if you experience excessive pain or swelling, stiffness or numbness it is always advisable to seek prompt assessment from your surgeon or treating doctor. A small percent of clients will experience complications following operative management for Dupuytren's contracture. Any complication following hand surgery is best diagnosed quickly.
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Author Jo Marsh
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