Fasciotomy

This simply means cutting the tight cord or band of tight tissue. It can be performed by percutaneous and open methods. There have been a number of articles in the press relating to the percutaneous technique, especially from Paris. This procedure is performed as a daycase under local anaesthesia and simply involves the cutting of the tight band of the contracture. In my opinion the deciding factor as to whether I use the percutaneous or open technique, is the quality of skin overlying the cord.  If it is still very mobile then the percutaneous technique works very well but if the skin is stuck to the cord then I prefer the open procedure. 

With the percutaneous technique a bandage is on for 24 hours and then reduced to a simple plaster for another couple of days.  In that time I would avoid any heavy gripping activities.

With the open technique the initial bandage will stay on for 48 hours before being reduced to a smaller dressing.  It can take up to ten days for the wound to heal fully and the hand be without dressings.