Minimally Invasive Technique for Release of Dupuytren's Contracture: Segmental Fasciectomy through Multiple Transverse Incisions

Abstract

Background A multitude of operative approaches have been described for treatment of Dupuytren's contracture. A less-invasive technique of segmental fasciectomies performed through multiple small transverse incisions is presented. Methods Seventy-three digits in 37 patients were treated with segmental fasciectomies. The results of 34 digits in 14 patients are described with subsequent follow-up longer than 2 years. Results Metacarpophalangeal joint extension improved from a mean of 32.5° to 2.2°, while proximal interphalangeal joint extension improved from 22.9° to 4.1°. Patients subjectively rated their surgical outcomes as excellent or good in 91.2% of cases. No recurrence of the disease was noted, though extension of the disease to adjacent digits was observed in three patients. Conclusions Though this approach is technically demanding and requires the help of a skilled assistant, this preliminary study supports our contention that this less-extensive procedure allows excellent correction of contractures; results in mild postoperative pain; and permits a rapid return of finger flexion with satisfactory long-term results so far at 2-years follow-up.