O28 - Long-term results after percutaneous needle fasciotomy for Dupuytren's contractureOther
1 Kungälvs sjukhus, Department of Surgery and Orthopedics
2 Sahlgrenska University Hospital, Department of Hand Surgery
3 Alingsås lasarett, Departement of Surgery and Orthopedics
Introduction: Needle fasciotomy (NF) is a well-established, minimally invasive treatment option for mild to moderate Dupuytren contractures but long-term results have indicated a high recurrence rate. This prospective study was initiated to monitor the safe introduction of NF in a context where limited fasciectomy had been the only treatment option for DC, and to investigate the long-term results.
Patients and Methods: The inclusion criterion was a palpable cord with an MCP and/or PIP contracture in one or more fingers. 58 fingers in 42 patients were treated by NF between November 2010 and March 2012, and were followed for a median of 6.5 years. Four patients (8 treated fingers) died during the follow-up period, and two patients (two treated fingers) declined follow-up. At the final follow-up of the remaining 48 treated fingers, 29 fingers had had no further treatment for Dupuytren contracture. Nineteen had undergone another (10) or were scheduled for a secondary procedure of the finger (9).
Results: At baseline, the median total passive extension deficit (TPED) was 52°(range 15-166°). The median MCP contracture was 45°(range -30°– 92°), and the median PIP contracture for patients with PIP involvement (defined as extension deficit >5°) was 34°(29 fingers). TPED decreased significantly to 20°(range -10°-142°) postoperatively. At final-follow up the median TPED was 22.5°(range -35°-135°) for all fingers. MCP extension was 0°(range -40°– 70°).
Conclusions: NF is a simple and safe procedure for Dupuytren’s contracture, but with a recurrence rate that has to be taken into account. However, 29 fingers retained a straight finger at the final follow-up.