A Longitudinal Analysis of 281 Cases of Dermofasciectomy Efficacy in Advanced Dupuytren Disease Cases: A 20-Year Perspective.

PURPOSE: This study aimed to evaluate the long-term efficacy and outcomes of dermofasciectomy in patients with advanced Dupuytren disease over a 20-year period.

METHODS

A longitudinal analysis was conducted on 281 cases of advanced Dupuytren disease treated with dermofasciectomy. Disease severity, surgical techniques, rates of proximal interphalangeal joint contracture recurrences, disease recurrence, wound complications, and postoperative care protocols were systematically recorded and analyzed.

RESULTS

A total of 281 cases were reviewed, with patients undergoing dermofasciectomy for advanced Dupuytren disease. Full-thickness skin graft loss occurred in 1.1% of cases, with partial loss in 4.2%, primarily in diabetic patients. Junctional recurrence was observed in 3.1% of cases, with no recurrence under the graft itself. Functional outcomes were favorable, with 97% of patients reporting improved hand function. Nerve damage was minimal, with transient neuropraxia in 2.8% and only one case (0.4%) of persistent sensory loss.

CONCLUSIONS

Dermofasciectomy appears to be a highly effective surgical intervention for advanced Dupuytren disease, offering substantial long-term benefits in terms of function and disease control. These findings underscore the efficacy and durability of dermofasciectomy in managing advanced cases, particularly with appropriate postoperative care.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IIb.