Question:I have Dupuytren's disease in my right hand, and I'm scheduled to have surgery next week. The surgeon is going to make tiny cuts in my palm and then release the tight tissue. I will be awake for the operation. Will there be any pain involved?
Answer:Dupuytren's is a disease of unknown cause with thickening of the palmar fascia in the hand. Cords or bands of tissue form pulling the affected finger(s) into a flexed position. Surgery to release the tissue is the most successful treatment method.
There are several ways to do the surgery. The most common is a limited fasciectomy (LF). Limited fasciectomy is a partial removal of the fascia. The procedure is usually done under a general anesthesia. Only the diseased fascia is taken out.
As you've described your surgery, it sounds like you're having a fasciotomy. In this operation the surgeon cuts the bands to relieve tension or pressure. Small incisions in the palm allow the surgeon to pass special tools under the skin to do this. The patient is awake but the hand is numb.
The cords or bands of tissue don't have any sensation or nerve endings for pain. Cutting these isn't painful at all. However, the nerves in the hand will respond if the surgeon comes too close with the needle. You may feel a strong electric-current sensation at the tip of the finger. Let the surgeon know right away if you feel this. He or she can redirect or move the needle away from the nerve and avoid causing any damage.Annet L. van Rijssen, MD, et al. A Comparison of Direct Outcomes of Percutaneous Needle Fasciotomy and Limited Fasciectomy for Dupuytren's Disease: A 6-Week Follow-Up Study. In The Journal of Hand Surgery. May-June 2006. Vol. 31A. No. 5. Pp. 717-725.
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