What is Dupuytren's Disease | London & Essex?

Professor Ben Miranda provides specialist treatment for Dupuytren's disease through targeted hand surgery options in both London and Essex. This condition develops over time, affecting the deep tissue (fascia) of the palm and fingers.

Over time, the fascia thickens into nodules that form longitudinal fibrous cords. These cords can cause the fingers to bend toward the palm—a flexion deformity—and may lead to permanent stiffness or flexion contractures if untreated. Early symptoms may include puckering or dimpling of the skin. Although often painless, the disease can become uncomfortable.

Dupuytren’s disease is frequently hereditary and is more common in men and individuals with diabetes, epilepsy, or liver disease. Those with a history of hand trauma, or lifestyle factors such as alcohol use and smoking, may also be at increased risk. Early-onset cases (under 50 years), bilateral involvement, family history, or associated fibromatosis elsewhere (e.g., feet) often indicate more aggressive progression and a higher chance of recurrence post-treatment.

Telephone: 020 3763 7999

Email: secretary@BenMiranda.com 

What types of Dupuytren's Disease Hand Surgery are Available in London & Essex?

Fasciotomy: This is usually performed under local anaesthetic and is a relatively minimally-invasive procedure. The fibrous cords are released via small incisions in the palm or finger using either a needle (needle aponeurotomy) or blade. This procedure may be suitable for well-defined cords, palmar involvement, mild contractures or in patients who are unfit / unsuitable for more complicated surgery. Although there is a faster recovery, fasciotomy does have complications and a higher recurrence rate than other techinques.

• Anaesthetic: Local anaesthetic.

• Surgery Time: 15 minutes.

• Hospital Stay: Day case.

• Recovery Time: 1 week.

• Time off Work: 1-2 weeks.

Fasciectomy: The fibrous cords are removed, usually under regional or general anaesthetic. The entire wound is stitched up and may have a zig-zag appearance to help lengthen the skin. Very rarely, a skin graft may be required in very advanced disease, or, a small part of the wound may be intentionally left open to heal by itself (open-palm technique); this will avoid the requirement for a skin graft and has no detrimental effect to your overall function.

• Anaesthetic: Regional or general anaesthetic.

• Surgery Time: 60-90 minutes.

• Hospital Stay: Day case.

• Recovery Time : 4-8 weeks.

• Time off Work: 6-8 weeks.

Dermofasciectomy: In some cases of very advanced disease, a portion of overlying skin needs to be removed along with the underlying fibrous cords, and a skin graft is applied to the defect. This procedure may be necessary in cases where the overlying skin is extensively affected by disease, in recurrent cases, or in young patients (20-40 years) who almost always have recurrence after fasciectomy. Dermofasciectomy is a more complicated operation with a longer recovery time than fasciectomy, however it does offer a lower recurrence rate in the previously discussed circumstances.

• Anaesthetic: Regional or general anaesthetic.

• Surgery Time: 60-120 minutes.

• Hospital Stay: Day Case.

• Recovery Time: 6-12 weeks.

• Time off work: 6-12 weeks.

What are the complications of Dupuytren's Disease Hand Surgery?

Professor Ben Miranda minimizes surgical risks through expert technique, attentive post-operative care, and structured hand therapy follow-up. Patients undergoing Dupuytren's disease surgery in London or Essex benefit from an experienced team dedicated to optimal outcomes.

• Fasciotomy: Lower risk, quicker recovery, but higher recurrence—up to 80% at 2 years

• Fasciectomy/Dermofasciectomy: More complex procedures, lower recurrence (10–20% at 5 years)

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Other potential risks include:

• Infection

• Bleeding

• Nerve or vessel injury (numbness or stiffness)

• Tendon injury

• Complex regional pain syndrome

• Poor scarring or wound breakdown

• Incomplete release or recurrence (especially in the PIP joint)

Regardless of procedure type, Dupuytren’s surgery with Professor Ben Miranda ensures a high standard of care in London Harley Street and Essex (Chelmsford & Southend).