It can take a long time to recover full or partial function of the hand after surgery for Dupuytren’s contracture (Dupuytren's disease). Generally, the more extensive your surgery, the longer your recovery time.
It's important to discuss your recovery and any aftercare procedures you may need with your specialist before having surgery.
After surgery, you may need specialised hand therapy to help improve the function and range of movement of your hand. For example, you may need to have:
- physiotherapy – this could involve a number of techniques to help improve your range of movement, including massage, manipulation and exercise
- occupational therapy – if you're struggling with everyday tasks and activities, either at work or at home, an occupational therapist will be able to provide you with practical support to make those tasks easier
How long you'll need to have treatment or assistance for depends on the type of surgery you've had. For example, you may need hand therapy for up to six months after more extensive procedures.
Splinting usually involves bandaging your fingers to a plastic strip while they're in the straightest position you find comfortable. Splinting may initially be recommended all day, before being used only at night, and then not at all.
Splinting isn't currently a standard procedure and some specialists prefer not to use splints. When splints are used, there's often wide variation in the length of time they're used for, the position of the fingers and how much force is used to keep the fingers straight.
Some specialists believe splints can positively influence the way that scar tissue forms after surgery, so that the scar doesn't contract and cause the condition to return. Others believe splints can cause unnecessary pain, joint stiffness and swelling (oedema), so prefer not to use them.
Several research studies have been carried out to try to determine whether or not using splints is effective in the recovery of Dupuytren’s contracture.
One study found that there was no difference between the range of hand movement experienced by a group of people who were routinely splinted after having types of surgery called a fasciectomy or a dermofasciectomy, and a group who received hand therapy and were only splinted if contractures occurred.
After having hand surgery, you can start driving as soon as you feel confident enough to control the car safely. This will usually be after about three weeks, but it may be longer if you've had a skin graft.
Work and sport
When you'll be able to return to work depends on the nature of your job and the type of operation you've had.
If you do heavy manual work, you may not be able to return to work for six weeks after having a skin graft. If you work in an office, you may be able to return to light duties a few days after having a fasciotomy. The same advice applies to sport.
Surgery can help improve hand function in people affected by contractures, but it doesn't stop the process that caused the contracture to develop in the first place. Therefore, there's a chance the condition may return in the same place, or it may reappear somewhere else after treatment.
Recurrence is more likely to occur in younger people, people who had a severe contracture and those with a strong family history of the condition.
The chances of the condition returning after surgery also depend on the specific procedure you had. Dupuytren's contracture recurs in more than half of people who have a type of minor procedure called a needle fasciotomy, but only about one in three people who have a fasciectomy. A dermofasciectomy is associated with the lowest risk of recurrence, with the condition reappearing in less than 1 in 10 people after the procedure.
The experience of the surgeon who carries out the procedure may also influence the chance of recurrence.