External Fixation
When would I require an external fixator?
In the event that there is a severe contracture of one of the joints of the finger or a difficult recurrence, a two stage procedure which involves the use of a device called an external fixator is necessary.
In the first stage an external fixator is applied to straighten the finger. This is followed by a dermofasciectomy and a full thickness skin graft four to six weeks later.
What problems can occur following external fixation for Dupuytren's contracture?
Just like any other operation, external fixation for Dupuytren's contracture can have post operative problems such as bleeding, haematoma formation, infection or delayed healing of the wound.
The sensation at the tips of the fingers can change, the scars can be tight and in time patients can develop a recurrence at the site of surgery or new disease may develop in other parts of the hand which is unrelated to the part that has been operated upon.
The use of a full thickness skin graft is usually protective against a recurrence in the operative area in most cases.
What is the normal post operative course following external fixation?
Patients who have an external fixator applied for severe or recurrent contractures are shown how to care for the fixator both in terms of cleaning and maintaining mobility of the joints.
Following the second procedure, which is a dermofasciectomy and full thickness skin graft, patients are instructed regarding care of the skin graft and splintage/mobilisation of the joints with a hand therapist.
