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