DUPUYTRENS FASCIECTOMY
Therapy Guide

 

  • Removal of contracted palmar fascia to improve fixed flexion deformity
  • Palmar zig-zag incisions
  • POP with bulky dressing holding affected digits in extension for 10/7
  • Rehab begins on removal of POP
  • Volar based night extension splint to be worn for 6 months (or more if needed)

Exercises – To be done every hour

  • Warm up hand by making fist then straightening fingers >20x
  • Scar massage using hand cream x 10 minutes
  • Sustained finger extension stretch (either individual joints or gross composite) – hold for at least 3 minutes
  • Sustained finger flexion stretch (either individual joints or gross composite) – hold for at least 3 minutes

Look out for

  • Major swelling – ensure elevation.  Use Coban wrap
  • CRPS.  Ensure full Physiotherapy rehab program!
  • Infection – send to GP urgently for antibiotics
    Overpushing of joints, especially PIPJ’s tends to flare the joints up, therefore firm sustained stretches are by far the best method for achieving range
  • If patient has OA in his finger joints then regaining ROM can be quite a struggle and will need increased input
 
 

The Hand to Elbow Clinic
29a James Street West
Bath BA1 2BT

Tel 01225 316895
Fax 01225 484949
info@handtoelbow.com
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