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Needle Aponeurotomy for Dupuytren's Contracture: Before Your Procedure

A normal hand and a hand with Dupuytren's disease

What is needle aponeurotomy?

Needle aponeurotomy is a procedure used to straighten bent fingers caused by Dupuytren's (say "duh-pwee-TRAHNZ") disease.

This disease can change how your hand looks. You may find it hard or impossible to use one or more of your fingers.

The disease causes tissue under the skin of the palm of your hand to thicken and shorten. This can pull and bend the fingers in toward the palm. You may not be able to straighten them. This is called a contracture.

Your doctor will numb the affected area of your hand. The doctor will then place a needle into the tissue that is bending your fingers. Your doctor will use the needle to put holes in the tissue. Then the doctor will straighten your fingers. This causes the tissue to separate and release your fingers.

The procedure causes little pain. But your fingers may be numb for a few hours after the procedure. You may notice tingling in the fingers for the next few days.

After the procedure, your doctor may inject corticosteroid medicine in your hand. This reduces swelling. You will have bandages put on your hand.

The procedure can be done in your doctor's office. It takes 20 to 30 minutes.

It will probably take about 1 to 2 weeks for your hand to heal. How soon you can go back to work depends on your job. If you can do your job without using your hand or with light use, such as working at a computer, you may be able to go back in 1 to 2 days. But if your job requires you to use a lot of hand strength, to grip things tightly, or to get your hands dirty, you may need to take about 1 to 3 weeks off work.

For the first few weeks after this procedure, you will probably need to wear a splint part of the time. You may need to do hand exercises to help reduce the swelling and stiffness.

How do you prepare for the procedure?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

  • You may need to shower or bathe with a special soap the night before and the morning of your procedure. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after the procedure.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what procedure is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

What happens on the day of the procedure?

  • Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.
  • You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.

At the doctor's office or surgery centre

  • Bring a picture ID.
  • The procedure takes 20 to 30 minutes.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your procedure.
  • You become ill before the procedure (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the procedure.

Where can you learn more?

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