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Palmar Fasciectomy is a surgical procedure performed to treat Dupuytren's contracture. In this procedure, the surgeon makes a small incision in the palm to access the thickened tissue. The affected fascia (the fibrous tissue) is carefully removed to release the tight bands causing the fingers to bend. This allows the fingers to straighten and restores hand movement.
Depending on the severity of the condition, the surgery may be done under local anaesthesia, where only the hand is numbed, or under general anaesthesia. After the surgery, patients typically undergo a period of rehabilitation to regain full hand function and prevent the contracture from returning.
Palmar fasciectomy is performed to treat Dupuytren's contracture, a condition characterised by thickened tissue in the palm that causes the fingers to curl inward. The aim is to restore hand function by removing the affected fascia. This surgery is recommended when non-surgical treatments fail. It helps patients regain hand flexibility and improve their grip.
See a doctor if you notice painless thickening or nodules in your palm, especially if your fingers start curling. Problems placing your hand flat on a surface or difficulties with everyday activities are vital signs. Early intervention can help reduce complications. A hand specialist can confirm the diagnosis and determine if surgery is necessary.
Before surgery, your surgeon may ask for X-rays, blood tests, and a physical examination of your hand. You might need to stop taking blood-thinning medications. Make plans for someone to drive you home after the surgery. Preoperative instructions will include hygiene steps and fasting guidelines if you need general anesthesia.
During a palmar fasciectomy, a surgeon makes an incision in the palm to access and remove the thickened tissue cords. The surgery can be performed under local, regional, or general anesthesia. Care is taken to protect nerves and tendons during the procedure. Afterwards, the wound is closed with stitches and bandaged.
The procedure usually takes 1 to 2 hours, depending on the severity and number of fingers involved. It is often done as an outpatient surgery so that you may go home the same day. Recovery begins almost immediately with hand elevation and wound care. Hand therapy typically starts soon after the healing process is complete.
- Infection at the surgical site
- Injury to nerves or blood vessels
- Finger stiffness or loss of motion
- The contracture may recur over time
- Scarring and delayed wound healing
- Increased finger extension and flexibility
- Restored the ability to perform daily tasks
- Long-term relief from contracture symptoms
- Minimal recurrence in carefully selected cases
- Improved hand appearance and strength
Recovery involves wound care, elevation, and physical therapy to help regain strength and mobility. Most patients can return to light use of their hand in 2 to 3 weeks. Full recovery, including grip strength and mobility, may take up to 3 months. Occupational therapy may be necessary for optimal results.
The success rate for palmar fasciectomy is high, with 70-90% of patients experiencing significant improvement in hand function. However, the condition can come back over time, especially in severe cases or among younger patients. Success is most important when combined with hand therapy and proper follow-up care.
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+99Process Involved for Palmar Fasciectomy
Treatment Stages for Palmar Fasciectomy are:-
- Evaluation – The surgeon assesses the hand’s condition, finger mobility, and severity of contracture to determine suitability for surgery.
- Preoperative Planning: Imaging and blood tests may be performed; patients are advised about the procedure, risks, and recovery.
- Anaesthesia – Local, regional, or general anaesthesia is administered based on the case complexity and patient preference.
- Surgical Procedure – The surgeon carefully removes the thickened fascia from the palm to release the contracted fingers.
- Wound Closure – The incision is closed using sutures, and a dressing is applied to protect the site.
- Recovery & Rehab – Patients undergophysiotherapy and hand exercises to regain strength, flexibility, and full function.
- Follow-up – Scheduled visits ensure healing and monitor for recurrence or complications.
Conditions treated by Palmar Fasciectomy:
- Dupuytren’s Contracture – The primary condition treated is where thickened tissue in the palm causes fingers (especially the ring and little fingers) to bend inward.
- Fibromatosis – A broader fibrous tissue disorder that may result in thickened cords in the hand, affecting mobility.
- Recurrent Contracture – In cases where a previous surgery failed or the condition returned, palmar fasciectomy is performed again to restore hand function.
- Functional Impairment—This surgery can significantly helppatients experiencing difficulty gripping or opening the hand due to fibrous bands.
- Severe Hand Deformity—This surgical procedure can correct or improve Advanced cases of contracture, which can cause deformity and disability.
- Assessment – The surgeon evaluates the hand’s condition, examining the severity of contracture and mobility of fingers to determine if surgery is needed.
- Preparation – The area for surgery is cleaned and sterilised, and the surgeon marks the incisions to guide the procedure.
- Anaesthesia – Depending on the case, the patient is given either local, regional, or general anaesthesia for comfort during the procedure.
- Surgical Incision – The surgeon makes an incision in the palm and possibly fingers to access the affected tissue.
- Tissue Removal – The thickened fascia is carefully excised, releasing the contracture, with precautions to preserve nearby structures.
- Closure – After controlling any bleeding, the incision is sutured, and the area is covered with a sterile dressing to prevent infection.
- Recovery Monitoring – The patient is monitored for immediate complications, and the hand is elevated to reduce swelling.
- Post-Surgery Rehabilitation – Physiotherapy and hand exercises begin to restore the full range of motion, strength, and functionality.
- Fasciotomy
- Dermofasciectomy
- Tenolysis
- Z-plasty
- Grafting
- Splinting
- Debridement
- Physiotherapy
Benefits of Palmar Fasciectomy include:
- Relief – The procedure effectively releases tight bands in the palm, reducing hand contracture caused by Dupuytren’s disease and easing discomfort.
- Mobility – It significantly enhances the range of motion in affected fingers, allowing smoother and more natural hand movements.
- Function – By improving finger extension, patients regain the ability to perform essential daily tasks like writing, grasping, and lifting.
- Precision – Surgeons can target and remove only the diseased tissue, preserving healthy structures and reducing the risk of complications.
- Recovery – Most individuals experience sustained improvement and minimal recurrence with appropriate post-operative physiotherapy.
- Independence – Restored hand function increases self-reliance in personal care and occupational duties, improving overall quality of life.
The following are the treating team members for Palmar Fasciectomy:
- Surgeon
- Anesthesiologist
- Nurse
- Physiotherapist
- Technician
- Assistant
- Counselor
- Coordinator
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