Improvement in the Appearance and Function of the Hand at 2 Weeks after Percutaneous Needle Fasciotomy for Dupuytren Disease

Author:

JOHNSON Nick1,KURIEN Tom1,SELBY Anna1,O’BRIEN Mary1

Affiliation:

1. Pulvertaft Hand Centre, Derby, UK

Abstract

Background: Percutaneous needle fasciotomy (PNF) has been successfully used for the treatment of contracture bands in the hand in patients with Dupuytren disease. The aim of this study is to determine aesthetic and functional outcomes at 2 weeks following PNF in patients with Dupuytren contracture. Methods: Seventy-five patients undergoing PNF for Dupuytren disease during a 4-month period were included. Patients completed the Visual Analogue Appearance Score (VAAS), Derriford Appearance Score (DAS), and the quick Disabilities of the Arm, Shoulder and Hand score (QuickDASH) preoperatively and at 2 weeks after surgery. In addition, VAAS was done in the immediate postoperative period as well. Results: Seventy-four (99%) patients completed the immediate postoperative VAAS scores and 51 (68%) completed the VAAS, DAS, and QuickDASH at 2 weeks. Preoperative VAAS fell from 6.01 to 1.53 (p < 0.0001) immediately post operation. Two weeks later, VAAS increased to 2.91 but was still significantly lower than preoperatively (p < 0.0001). DAS was unchanged. QuickDASH decreased from 22.4 preoperatively to 12.1 2 weeks later (p = 0.001). Conclusion: PNF for Dupuytren contracture resulted in improvement in both aesthetic and functional outcomes at 2 weeks. Longer term follow-up is required to determine whether these improvements are sustained. Level of Evidence: Level IV (Therapeutic)

Publisher

World Scientific Pub Co Pte Ltd

Subject

General Medicine

Reference19 articles.

1. Adams W. On Contractions of the Fingers (Dupuytren’s and Congenital Contractions) and on “hammertoe”: Including Two Essays on Dupuytren’s Contraction of the Fingers, and Its Successful Treatment by Subcutaneous Divisions of the Palmar Fascia, and Immediate Extension. One Essay on Congenital Contraction of the Fingers and Its Association with Hammer-toe: Its Pathology and Treatment. One Essay on the Successful Treatment of Hammer-toe, by the Subcutaneous Division of the Lateral Ligaments. And One Essay on the Obliteration of Depressed Cicatrices After Glandular Abscesses, Or Exfoliation of Bone, by a Subcutaneous Operation. J. & A. Churchill; 1892.

2. Dupuytrenʼs Contracture

3. Percutaneous Needle Aponeurotomy: Complications and Results

4. Results of Needle Aponeurotomy for Dupuytren Contracture in Over 1,000 Fingers

5. Five-Year Results of a Randomized Clinical Trial on Treatment in Dupuytrenʼs Disease

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