What is palmar fasciectomy/surgical removal?

A palmar fasciectomy is a surgery to remove all or part of the palmar fascia. This is a thin sheet of connective tissue in your hand. It's shaped like a triangle. It's beneath the skin on your fingers and the palm of your hands. Your surgeon cleans the skin, makes an incision and exposes the palmar fascia. Then they separate it from the nearby tendons and nerves before removing diseased tissue.

What to expect from palmar fasciectomy/surgical removal

There are two versions of this treatment: partial and total. If you have a partial palmar fasciectomy, your doctor removes only the abnormal tissue in your affected hand. In a total palmar fasciectomy, your doctor removes all the fascia, even if it's not causing any problems. Once the surgery's over, they may close the incision completely. They also may leave a small part open so it can drain.

Before you have the operation, your doctor evaluates your condition to determine how many fingers need treatment. They also decide whether to put you to sleep during the surgery or do it with a local anesthetic that lets you stay awake. This is an outpatient surgery that lasts one or more hours. Most patients go home the same day.

Your doctor wraps your hand with gauze or small bandages after the surgery. You may need to keep your hand elevated and apply ice for the first few days. Physical therapy usually isn't necessary. Most patients can get back to normal activities within one week.

Common conditions requiring palmar fasciectomy/surgical removal

Doctors often do this surgery to treat Dupuytren's contracture. This hand deformity happens when abnormal tissue forms in the fascia under your palm. That fascia is connective tissue that holds the skin of your palm in place. The way this condition affects that tissue leaves most patients with the loss of normal hand function. As it gets worse, your doctor may start talking about your surgical options.

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