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WHAT YOU SHOULD KNOW:
- Dupuytren's disease is a condition that makes some of the tissue in your hand thicken. The tissue may form cords that start on your palm and go to your finger. If the cord contracts (becomes shorter), then your palm or finger may become stuck in a bent position. Dupuytren's disease may occur in one or both of your hands. Any finger may become bent, but it is more common in your ring and little finger. With Dupuytren's disease, you may first notice dimples or pits on your palm. You may feel bumps or cords of tissue on your palm and your finger may become bent. Caregivers do not know what causes Dupuytren's disease, but think it may be inherited (runs in the family).
- Your caregiver will ask you questions about your health and will examine your hands. You may need medicine to decrease the size of your lump and make it softer. You may also need surgery to weaken or remove the cord of tissue in your palm and fingers. Dupuytren's disease is a progressive disease, which means it gets worse over time. Dupuytren's disease may happen many times over your lifetime and your finger may never fully become unbent. Treatment may help decrease your pain. Your finger may become less bent and it may be easier to use your hand.
CARE AGREEMENT:You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
- Steroid shots may be painful and may cause your skin to become stiff or lighter in color. You may get an infection or a pocket of fluid may form under your skin. After injection treatments, your hand may have bruising, stiffness, redness, or swelling. You may get a scar or joint damage that makes your hand or finger become bent again. Other tissues such as tendons may be damaged and you may not be able to move your hand or finger. If this happens, you may need surgery to fix it. You may also have very bad pain or lose feeling in your hand. You may have damage to your nerves or blood vessels. Your wound (surgery site) may not heal well and nearby tissue may die. If too much tissue dies, you may need to have your finger amputated (removed).
- Even after surgery, you may not be able to fully straighten your fingers. You may also have trouble bending your fingers. You may get Dupuytren's disease again. You may need another surgery. Without treatment, it may be hard for you to do your usual daily activities. You may have problems washing, dressing, playing sports, or driving. Your Dupuytren's disease may get worse and you may not be able to use your hand at all. Ask your caregiver if you have concerns or questions about your treatment, condition, or care.
WHILE YOU ARE HERE:
is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
is a small tube placed in your vein that is used to give you medicine or liquids.
- Proteolytic enzymes: This medicine is given as one or more shots into your hand. This medicine may decrease the contractures (muscle shortening) that cause your fingers to stay bent.
- Steroids: Steroid medicine is given as one or more shots into your lump. Steroids may make the lump softer or less painful. You may need to have this treatment more than once.
- Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
- Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
- Nerve block: A nerve block is a shot of medicine that makes you lose feeling in an area of your body. You may need a nerve block if your pain is not going away, or is getting worse. A nerve block may also be used to make you lose feeling in an area before a procedure is done.
- Antibiotics: Your caregiver may give you antibiotic medicine before surgery to help treat or prevent an infection. This medicine may be given to you as a pill or through your IV.
- Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.
- General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.
- Local or monitored anesthesia: Anesthesia is medicine that keeps you from feeling pain during surgery or a procedure. Local anesthesia is a shot of numbing medicine put into the skin where you will have surgery. You will be fully awake during the surgery or procedure. You may feel pressure or pushing, but you will not feel pain. Monitored anesthesia means you will also be given medicine through an IV. This medicine keeps you comfortable, relaxed, and drowsy during the surgery or procedure.
- Surgery: You may need surgery if your hand becomes bent. Even after surgery, your finger or palm may remain partially bent. There are different kinds of surgery that can be done for your condition. You may need any of the following:
- Fasciotomy: During a fasciotomy, your caregiver uses a special needle or knife to divide cords in your palm or finger. This surgery may be done in your caregiver's office.
- Fasciectomy: With this surgery, some or all of the thick tissue and cords are removed. Your wound (surgery site) may be closed with stitches or left open to heal on its own. Your wound is covered with bandages. During a fasciectomy, some of your skin may need to be removed. If this happens, your hand will be covered with skin taken from another part of your body.
- Joint surgery: You may need surgery on your joints. Joints are the places in your body where two bones meet. Joints in your hand include your knuckles and other places where your fingers bend. Your caregiver may do joint surgery to make your joint looser or fixed in one place.
- Amputation: You may need an amputation if your finger is not made better by other surgeries. During an amputation, part or all of your finger is removed.
- Drains: After surgery, you may need a drain put in your wound (surgery site). These are thin rubber tubes put into your skin to drain fluid from around your incision (surgery cut). The drains are taken out when the incision stops draining.
- Dressings: Your caregiver may put bulky dressings on your hand after your surgery. He may also put a splint on your hand. This splint may stretch your fingers so that they are fully extended.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.