RESEARCH ARTICLE


The Re-Emergence of Percutaneous Fasciotomy in the Management of Dupuytren’s Disease



James Donaldson* , Nicholas Goddard
Department of Trauma and Orthopaedics, Royal Free Hospital, Hampstead, London, UK


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© Donaldson and Goddard; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Trauma and Orthopaedics, Royal Free Hospital, Hampstead, London, UK; Tel: 02077940500; Fax: 02077940501; E-mail: jamesrdonaldson@gmail.com


Abstract

Dupuytren’s disease is a common condition. Its management has gradually evolved but still remains a source of much controversy. Recently there has been a resurgence in the popularity of percutaneous needle fasciotomy. It is a simple method that uses a hypodermic needle as a scalpel blade. It is usually performed in the out-patient setting under local anaesthesia without a tourniquet. It has few complications and allows almost immediate return to work with few restrictions.

It can provide complete deformity correction and may offer a long-term solution in selected patients. It is also useful in converting advanced contractures into milder deformities, allowing a second stage digito-palmar fasciectomy to be more successful. Recurrence is earlier than with more formal and invasive techniques but the procedure can be repeated and does not preclude the patient from further surgery.

This article reviews the technique and assesses the efficacy and outcomes of published data.

Keywords: Dupuytren’s disease, percutaneous needle fasciotomy.