Soft tissue procedure: release of dupuytrens contracture
50 yr old retired army man ,
alcoholic and smoker, came to us with complaints of gradual infolding of little
finger and ring finger of right hand. The deformity was more in little finger,
wherein the finger could not be opened up to much extent. Upon attempted
extension passively, a fibrous constricting band could be felt right beneath
the skin. X rays were done and any deforming arthritis ruled out. The patient
was taken to operation theatre and surgical extension of constricting band was
done. It is very important in this surgery to plan the surgical incisions and
preserve the palmar skin. As the band is removed, the finger can be extended to
full range. However, once extended, there is a big soft tissue defect in palm
which can be managed by vy plasty and skin grafting. The fingers are mobilized
early and any hematoma under grafted skin is avoided. Once wounds are fully
healed, more aggressive grip strengthening can be started.