Perioperative management - Partial Fasciectomy for Dupuytren's Disease

• Flexion contracture of the MCP and/or PIP joint of more than 30°
• Significant restriction of hand function

• Local or general conditions that surgically or anesthesiologically contraindicate an elective operation or that can be improved preoperatively

• Clinical Examination:
  → Inspection/Palpation of the typical Dupuytren's tissue with flexion deformity of the joint

• no special preparation of the patient necessary
• generally outpatient procedure
• Clarification of contraindications for exsanguination (e.g. existing shunt in dialysis)

Informed consent about

• surgical method
• extension procedure such as e.g. reconstruction artery/nerve, skin graft

• general surgical risks
  • wound healing disorder
  • tendon injury
  • functional deficit wrist/hand
  • CRPS = Sudeck's disease

• specific surgical risks
  • injury to vessel/nerve bundle with corresponding consequences
  • skin necrosis
  • recurrence
  • activation of the disease
  • scar contracture
  • protracted scar pain (usually subsides after 6 months)