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Percutaneous needle fasciotomy for recurrent Dupuytren disease.
J Hand Surg Am. 2012 Sep; 37(9):1820-3.JH

Abstract

PURPOSE

Increasing options to treat Dupuytren disease include percutaneous needle fasciotomy (PNF), a minimally invasive technique that has proven to be effective for the treatment of primary disease. However, its effect on recurrent disease is not clear.

METHODS

We studied 30 patients with recurrent Dupuytren disease in 40 fingers, with a mean follow-up of 4.4 years. Primary outcome measures were total passive extension deficit reduction and interval to a second recurrence, defined as an increase of more than 30° compared with the result at the end of the previous treatment. We noted complications.

RESULTS

Total passive extension reduction was 76%. Percutaneous needle fasciotomy was especially effective for the metacarpophalangeal joint, with an average reduction of 93%, whereas the average reduction in the proximal interphalangeal joint was 57%. A total of 50% of patients did not develop a secondary recurrence during follow-up. The other 50% did, and we treated recurrence within an average of 1.4 years after PNF. By means of PNF, we postponed tertiary treatment an average of 2.9 years starting from the initial treatment for Dupuytren disease. We successfully treated all secondary recurrences by limited fasciectomy, according to patients' wishes. We noted no major adverse effects.

CONCLUSIONS

Percutaneous needle fasciotomy can be applied effectively for recurrent disease; 50% of patients remain free of recurrence for a mean of 4.4 years. If a secondary recurrence occurs, it does so relatively early after treatment. Patients must therefore be willing to accept this uncertainty in the context of the advantages of PNF, such as fast recovery, low complication rate, and minimal invasiveness.

Authors+Show Affiliations

Department for Plastic, Reconstructive, and Hand Surgery, Isala Clinics, Zwolle, The Netherlands. annetvanrijssen@hotmail.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22763055

Citation

van Rijssen, Annet L., and Paul M N. Werker. "Percutaneous Needle Fasciotomy for Recurrent Dupuytren Disease." The Journal of Hand Surgery, vol. 37, no. 9, 2012, pp. 1820-3.
van Rijssen AL, Werker PM. Percutaneous needle fasciotomy for recurrent Dupuytren disease. J Hand Surg Am. 2012;37(9):1820-3.
van Rijssen, A. L., & Werker, P. M. (2012). Percutaneous needle fasciotomy for recurrent Dupuytren disease. The Journal of Hand Surgery, 37(9), 1820-3. https://doi.org/10.1016/j.jhsa.2012.05.022
van Rijssen AL, Werker PM. Percutaneous Needle Fasciotomy for Recurrent Dupuytren Disease. J Hand Surg Am. 2012;37(9):1820-3. PubMed PMID: 22763055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous needle fasciotomy for recurrent Dupuytren disease. AU - van Rijssen,Annet L, AU - Werker,Paul M N, Y1 - 2012/07/03/ PY - 2012/01/26/received PY - 2012/05/03/revised PY - 2012/05/03/accepted PY - 2012/7/6/entrez PY - 2012/7/6/pubmed PY - 2013/1/29/medline SP - 1820 EP - 3 JF - The Journal of hand surgery JO - J Hand Surg Am VL - 37 IS - 9 N2 - PURPOSE: Increasing options to treat Dupuytren disease include percutaneous needle fasciotomy (PNF), a minimally invasive technique that has proven to be effective for the treatment of primary disease. However, its effect on recurrent disease is not clear. METHODS: We studied 30 patients with recurrent Dupuytren disease in 40 fingers, with a mean follow-up of 4.4 years. Primary outcome measures were total passive extension deficit reduction and interval to a second recurrence, defined as an increase of more than 30° compared with the result at the end of the previous treatment. We noted complications. RESULTS: Total passive extension reduction was 76%. Percutaneous needle fasciotomy was especially effective for the metacarpophalangeal joint, with an average reduction of 93%, whereas the average reduction in the proximal interphalangeal joint was 57%. A total of 50% of patients did not develop a secondary recurrence during follow-up. The other 50% did, and we treated recurrence within an average of 1.4 years after PNF. By means of PNF, we postponed tertiary treatment an average of 2.9 years starting from the initial treatment for Dupuytren disease. We successfully treated all secondary recurrences by limited fasciectomy, according to patients' wishes. We noted no major adverse effects. CONCLUSIONS: Percutaneous needle fasciotomy can be applied effectively for recurrent disease; 50% of patients remain free of recurrence for a mean of 4.4 years. If a secondary recurrence occurs, it does so relatively early after treatment. Patients must therefore be willing to accept this uncertainty in the context of the advantages of PNF, such as fast recovery, low complication rate, and minimal invasiveness. SN - 1531-6564 UR - https://www.unboundmedicine.com/medline/citation/22763055/Percutaneous_needle_fasciotomy_for_recurrent_Dupuytren_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0363-5023(12)00691-0 DB - PRIME DP - Unbound Medicine ER -