Dupuytren's Dermofasciectomy: aftercare advice

Information for patients from the Hand Therapy Service

You have had surgery for a condition called Dupuytren's disease. For more information on the disease, please read the Trust's Dupuytren's disease leaflet.

Over the next few weeks you will be given advice by your therapist about your rehabilitation and the management of your hand. Getting a good result from this surgery is directly related to the effort you put into your rehabilitation, so please follow the advice and guidance below.

This leaflet will:

If you have any questions after reading this leaflet, please speak to your therapist.

How do I care for my hand / finger(s) after surgery?

Following your surgery, it is important to follow the rehabilitation steps below to help with your recovery. The effort you put in, will significantly increase your chances of a positive end result from this surgery.

General advice 

  1. Example of good hand elevation while lying down
    Example of good hand elevation while lying down
  2. Example of good hand elevation while sitting
    Example of good hand elevation while sitting

Wound care

Your surgery has included the need for a skin graft, where skin was taken from elsewhere on your body to replace diseased skin. This means you will have two wounds.

If you have any concerns about your wound, please contact your therapist, your GP, or your nearest Urgent Treatment Centre.

Splint care

Exercises

You need to complete the following exercises for the first four weeks after your surgery. After this time, follow the instructions given to you by your therapist.

The exercises should not be painful, but may feel slightly uncomfortable as your fingers and hand stretch.

Each exercise should be completed five times, every two hours.

Table top to flat fist exercise

  1. Start with your fingers as straight as possible.
    1. Start with your fingers as straight as possible.
  2. Keeping your fingers straight, slowly lower them towards your palm.
    2. Keeping your fingers straight, slowly lower them towards your palm.
  3. Now bend your fingers, so they are touching your palm.
    3. Now bend your fingers, so they are touching your palm.
  4. Bring your fingers back up, so they are as straight as possible.
    4. Bring your fingers back up, so they are as straight as possible.

Hook to full fist exercise

  1. Start with your fingers as straight as possible.
    1. Start with your fingers as straight as possible.
  2. Bend your fingers.
    2. Bend your fingers.
  3. Continue bending, until you are making a full fist with your hand.
    3. Continue bending, until you are making a full fist with your hand.
  4. Bring your fingers back up, so they are as straight as possible.
    4. Bring your fingers back up, so they are as straight as possible.

Touch each finger tip in turn with the tip of your thumb

  1. Touch your thumb to your index finger.
    1. Touch your thumb to your index finger.
  2. Touch your thumb to your middle finger.
    2. Touch your thumb to your middle finger.
  3. Touch your thumb to your ring finger.
    3. Touch your thumb to your ring finger.
  4. Touch your thumb to your little finger.
    4. Touch your thumb to your little finger.

Spread your fingers apart as far as possible and back

  1. Start with your fingers as straight as possible.
    1. Start with your fingers as straight as possible.
  2. Spread your fingers as far apart as possible.
    2. Spread your fingers as far apart as possible.
  3. Bring your fingers back up, so they are as straight as possible.
    3. Bring your fingers back up, so they are as straight as possible.

With your hand palm up on the table, try to touch all of the tips of your fingers to the table

  1. Rest your hand on a table, with your palm facing up.
    1. Rest your hand on a table, with your palm facing up.
  2. Try to touch each of your finger tips to the table.
    2. Try to touch each of your finger tips to the table.

It is normal for these exercises to be uncomfortable, but they should not cause pain. If they do:

Will I have follow-up appointments?

You may not have many therapy sessions if you are doing well with your recovery. Your therapist will discuss this with you.

When can I drive again?

Most patients can start driving again two weeks after their surgery, when they start removing their splint in the day. However, this will depend on how well your wound and particularly your graft is healing, and if you can perform an emergency stop and control your car safely. Please speak to your therapist or GP if you are unsure.

Further information

If you have any further questions, do not hesitate to ask your therapist.