This handout explains the follow-up care after surgical excision of Dupuytren’s cords. The constricting cords of the Dupuytren’s disease have been excised from around the nerve bundles and joints. A splint has been used to maintain your fingers in as straight a position as possible. If the splint feels tight, it’s okay to unwrap and rewrap the Ace bandages. Because of the local anesthetic that we used, you may notice a numbness or tingling sensation in your fingers for several hours. This is normal and should dissipate within a few days.

If the skin around the incision is red or if there is drainage coming out of it please call us right away. The phone number is at the bottom of this page. Go to the emergency room if this occurs at night or on a weekend. We recommend that you start physical therapy within 2-3 days after surgery to introduce gentle range of motion exercises. If you do not have an appointment to begin post-operative therapy, please contact our office and we will coordinate that for you.

Wound Care:

  • An external fixation device (e.g., Digit Widget) may be applied to hold a finger in extension that has a severe contraction.
  • Your arm will be placed in a bulky splint after surgery. This helps to protect the surgical site and lessen swelling. When bathing, put a plastic bag around your arm to keep the splint clean and dry.
  • Elevate your arm as much as possible each day during the healing process, to lessen the swelling and pain.

Pain Management:

  • You will receive a prescription for narcotic pain medication. Take the pain medication as it is prescribed, taking the right dose at the right time to best manage your pain. As it takes about 1 hour for the medication to take effect, it is important to “stay ahead” with your pain medication and avoid having to play “catch up” for a significant increase in pain.

  • Medication for nausea may also be provided. Please make sure to take this as directed, typically placed under the tongue (sublingual) to be absorbed in the mouth.
  • Please make sure to check with the postoperative nurse or the Bellevue Bone & Joint Physicians staff about how to manage your pain medication.
  • Please see the “Medications After Surgery” form for more instructions.
  • If you have uncomfortable side effects from the pain medication please call us.
  • It is normal to have some pain off and on for approximately one year after surgery, particularly in cold weather.

Driving:

  • Do not drive if you are taking narcotic medication, as it is not safe and against Washington state law. Taking medication can make you sleepy and delay your reaction time.

  • Once you are no longer taking narcotic medication, you may drive as soon as you can comfortably grip the steering wheel with both hands.

Activity:

  • You may have decreased use of the operative hand for about six weeks after surgery until the tissue heals.

  • Do not lift anything heavier than a pencil or pen until your sutures have been removed and you have been advised to advance your activity by your physician or therapist.

Follow-Up:

  • Schedule an office visit with hand therapy within 3 days following surgery. If a drain is installed to prevent fluid from accumulating in the surgical site, it can be removed by BBJP hand therapy within 3 days following surgery. Oral antibiotics should be taken 4 times a day until the drain is removed.

  • The sutures will be removed, sometimes in two stages, beginning 10-14 days after surgery.
  • Your arm will be placed in a splint or cast, depending on the level of protection needed.
  • A hand therapist will help to teach you exercises to lessen the scarring around the incision, improve range of motion, and when appropriate, increase your hand and arm strength.

Results:

Many patients who have Dupuytren’s cords removed will regain full range of motion of their fingers. Stiffness is common after surgery and decreases with use.


Thomas E. Trumble, M.D.

*Figures courtesy of Principles of Hand Surgery and Therapy by Thomas E. Trumble, MD, Ghazi M. Rayan, MD, Mark E. Baratz, MD and Jeffrey E. Budoff, MD