Percutaneous Needle Fasciotomy Versus Limited Fasciectomy for Dupuytren Disease: A Linear Model Assessment of Short-term Efficacy.

BACKGROUND

There is no consensus about the best treatment for Dupuytren contracture in the hand. In particular, whether to use a percutaneous needle fasciotomy (PCNF) in preference to a limited fasciectomy (LF).

METHODS

We performed a retrospective review of the outcomes of 74 joints treated with either PCNF or LF. Baseline characteristics, complications, and active extension deficit (AED) were assessed at 3 weeks and 3 months posttreatment. Reoperative procedures were analyzed to assess the effectiveness of repeated procedures.

RESULTS

Our results suggest that there is no significant difference between PCNF and LF in reducing AED at 3 weeks (P = 0.504) or 3 months (P = 0.66). Moreover, our data suggest that the risk of a surgical complication was the same for both procedures, after adjustment for confounders (P = 0.613). Our study suggests that a reoperative PCNF was 15.3% less effective in reducing the AED compared with a primary PCNF at 3 months postoperatively (P = 0.032); whereas there was no change in the effectiveness of a reoperative LF in reducing AED at both 3 weeks (P = 0.839) and 3 months (P = 0.449).

CONCLUSIONS

We believe that PCNF should be used as the primary treatment for nonrecurrent and recurrent Dupuytren contractures. More frequent use of PCNF may help to reduce waiting times for treatment and may enable better resource allocation. Further prospective studies should be carried out.