Needle fasciotomy for Dupuytren's contracture- a prospective cohort study of 58 fingers with a median follow-up of 6.5 years.

Abstract:

:Needle fasciotomy (NF) is a minimally invasive treatment option for Dupuytren contractures, but long-term results have indicated a high recurrence rate. This prospective study was initiated to monitor the introduction of NF in a context where limited fasciectomy had been the only treatment option, and to investigate the long-term results. The inclusion criterion was a palpable cord with a Metacarpophalangeal (MCP) and/or Proximal interphalangeal (PIP) contracture in one or more fingers. Fifty-eight fingers in 42 patients (40 male and 2 female with a median age of 68 years) were treated by needle fasciotomy between November 2010 and March 2012, and were followed for a median of 6.5 years. The median total passive extension deficit (TPED) was 52° at baseline, but decreased significantly to 20° postoperatively. No severe adverse events such as nerve or tendon injuries were reported. At final-follow up of 48 fingers the median TPED was still significantly reduced to 23° for all fingers (p < 0.0001). Twenty-nine fingers retained full correction of the contracture, and in patients with recurrent contractures NF was preferred in 13 out of 17 patients. This study showed that needle fasciotomy is a safe procedure for Dupuytren's contracture, with excellent immediate reduction of the joint contracture and with a recurrence rate comparable to treatment by collagenase clostridium histolyticum (CCH).

journal_name

J Plast Surg Hand Surg

authors

Zachrisson A,Sörensen AI,Strömberg J

doi

10.1080/2000656X.2019.1693391

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

89-93

issue

2

eissn

2000-656X

issn

2000-6764

journal_volume

54

pub_type

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