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Percutaneous needle fasciotomy in Dupuytren contracture: a register-based, observational cohort study on complications in 3,331 treated fingers in 2,257 patients.
Acta Orthop. 2020 06; 91(3):326-330.AO

Abstract

Background and purpose - Percutaneous needle fasciotomy (PNF) is a minimally invasive treatment option for Dupuytren contracture, which has gained momentum worldwide in recent years. However, evidence regarding safety and severe complications associated with PNF is sparse. Thus, we evaluated safety of a specific PNF method in the largest cohort reported in literature.Patients and methods - This is a single-center, register-based, observational study on PNF treatments between 2007 and 2015. The study cohort was identified by the Danish National Patient Registry, and diagnosis codes and procedure codes were used to identify potential severe postoperative complications such as: tendon rupture, nerve damage, infection, amputation, and reflex dystrophy for all index treatments. The Danish National Prescription Registry was used to identify non-hospital-treated infections. All index treatments and postoperative complications were verified by review of medical records.Results - 2,257 patients received PNF treatment of 3,331 treated finger rays. Median follow-up was 7.2 years (interquartile range: 4.9-9.5 years, range 1-12 years). 4 patients sustained flexor tendon rupture. 1 patient had digital nerve damage. 2 patients had an infection treated in hospital, while 31 patients received antibiotics in the primary sector for an infection or based on suspicion of an infection after PNF. None of the infections required surgical intervention. No finger amputations or ipsilateral upper limb reflex dystrophy cases were registered in relation to the procedure.Interpretation - Percutaneous needle fasciotomy for Dupuytren contracture is a safe procedure with a low rate of severe postoperative complications when a specific PNF method is applied.

Authors+Show Affiliations

Elective Surgery Centre, Silkeborg Regional Hospital, Denmark.Elective Surgery Centre, Silkeborg Regional Hospital, Denmark.Elective Surgery Centre, Silkeborg Regional Hospital, Denmark.Department of Orthopaedic Surgery, Horsens Regional Hospital, Denmark.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32056475

Citation

Therkelsen, Laura Houstrup, et al. "Percutaneous Needle Fasciotomy in Dupuytren Contracture: a Register-based, Observational Cohort Study On Complications in 3,331 Treated Fingers in 2,257 Patients." Acta Orthopaedica, vol. 91, no. 3, 2020, pp. 326-330.
Therkelsen LH, Skov ST, Laursen M, et al. Percutaneous needle fasciotomy in Dupuytren contracture: a register-based, observational cohort study on complications in 3,331 treated fingers in 2,257 patients. Acta Orthop. 2020;91(3):326-330.
Therkelsen, L. H., Skov, S. T., Laursen, M., & Lange, J. (2020). Percutaneous needle fasciotomy in Dupuytren contracture: a register-based, observational cohort study on complications in 3,331 treated fingers in 2,257 patients. Acta Orthopaedica, 91(3), 326-330. https://doi.org/10.1080/17453674.2020.1726057
Therkelsen LH, et al. Percutaneous Needle Fasciotomy in Dupuytren Contracture: a Register-based, Observational Cohort Study On Complications in 3,331 Treated Fingers in 2,257 Patients. Acta Orthop. 2020;91(3):326-330. PubMed PMID: 32056475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous needle fasciotomy in Dupuytren contracture: a register-based, observational cohort study on complications in 3,331 treated fingers in 2,257 patients. AU - Therkelsen,Laura Houstrup, AU - Skov,Simon Toftgaard, AU - Laursen,Malene, AU - Lange,Jeppe, Y1 - 2020/02/14/ PY - 2020/2/15/pubmed PY - 2020/8/5/medline PY - 2020/2/15/entrez SP - 326 EP - 330 JF - Acta orthopaedica JO - Acta Orthop VL - 91 IS - 3 N2 - Background and purpose - Percutaneous needle fasciotomy (PNF) is a minimally invasive treatment option for Dupuytren contracture, which has gained momentum worldwide in recent years. However, evidence regarding safety and severe complications associated with PNF is sparse. Thus, we evaluated safety of a specific PNF method in the largest cohort reported in literature.Patients and methods - This is a single-center, register-based, observational study on PNF treatments between 2007 and 2015. The study cohort was identified by the Danish National Patient Registry, and diagnosis codes and procedure codes were used to identify potential severe postoperative complications such as: tendon rupture, nerve damage, infection, amputation, and reflex dystrophy for all index treatments. The Danish National Prescription Registry was used to identify non-hospital-treated infections. All index treatments and postoperative complications were verified by review of medical records.Results - 2,257 patients received PNF treatment of 3,331 treated finger rays. Median follow-up was 7.2 years (interquartile range: 4.9-9.5 years, range 1-12 years). 4 patients sustained flexor tendon rupture. 1 patient had digital nerve damage. 2 patients had an infection treated in hospital, while 31 patients received antibiotics in the primary sector for an infection or based on suspicion of an infection after PNF. None of the infections required surgical intervention. No finger amputations or ipsilateral upper limb reflex dystrophy cases were registered in relation to the procedure.Interpretation - Percutaneous needle fasciotomy for Dupuytren contracture is a safe procedure with a low rate of severe postoperative complications when a specific PNF method is applied. SN - 1745-3682 UR - https://www.unboundmedicine.com/medline/citation/32056475/Percutaneous_needle_fasciotomy_in_Dupuytren_contracture:_a_register_based_observational_cohort_study_on_complications_in_3331_treated_fingers_in_2257_patients_ L2 - http://www.tandfonline.com/doi/full/10.1080/17453674.2020.1726057 DB - PRIME DP - Unbound Medicine ER -