I Have Dupuytren's Contracture: What Type of Fasciectomy Do I Need?

Dupuytren's contracture is a condition that affects the connective tissue in the hand and causes the fingers to bend inward. This limits movement and makes it hard to use your hand. You might also notice the cords of tissue in your palm, and unfortunately, the condition gets worse without treatment. 

If you’re facing this condition, seeking the right treatment can help you regain functionality and improve the quality of your life. Our board-certified surgeons at Sequoia Institute for Surgical Services may suggest surgery. Both fasciotomy and fasciectomy are treatments for Dupuytren’s contracture.

Read on as our team focuses on the types of fasciectomy and how you can tell which one best suits your individual needs.

Fasciotomy versus fasciectomy

A fasciotomy for Dupuytren's contracture involves making an incision in the affected fascia to alleviate tension and improve hand function, but it doesn’t remove the diseased tissue. Fasciotomy may be needed for less severe cases. If that’s true for you, our team offers two types of fasciotomy: needle fasciotomy and open fasciotomy. 

On the other hand, a fasciectomy requires surgically removing the thickened or contracted fascia. This option addresses the underlying condition and restores normal hand mobility.

Types of fasciectomy include

Depending on your needs, you may benefit from one of these types of fasciectomy:

Segmental (partial) fasciectomy

Segmental fasciectomy involves removing all of your affected tissue in segments. This helps preserve healthy tissue and maintain hand function.

This method is suitable for cases where the contracture extends along the length of your affected finger or involves multiple cords.

Regional fasciectomy

Regional fasciectomy is a more extensive procedure in which our team removes only the diseased tissue from a broader region of your hand.

We recommend this for cases with significant contracture that affects multiple fingers or when your condition has advanced.

Subtotal palmar fasciectomy

Subtotal palmar fasciectomy involves removing as much of the diseased fascia from your palm to provide the greatest release of contracture. 

Total palmar fasciectomy is typically considered for advanced cases of Dupuytren’s contracture where other, less invasive options may not be sufficient. Palmar fasciectomies require many incisions (often in a zigzag pattern) and skin grafts.

Dermofasciectomy

Dermofasciectomy involves removing both the affected fascia and the overlying skin. We follow it with skin grafting to cover the open wound.

Which type is best for you?

When you and your Sequoia Institute for Surgical Services hand surgeon discuss your surgery options, there are a few factors to consider. 

The type of surgery you need depends on:

• The severity of your condition
• How many fingers are involved
• Your surgeon’s recommendations 

Regardless of what type of surgery you need, you can expect post-surgery follow-up, suture removal, splinting, and physical therapy. To learn more about your options, call the location of your choice 一 Porterville, Reedley, or Visalia, California 一 or click here to book your appointment online.