Surgical alternatives in Dupuytren's contracture.

The treatment of Dupuytren's contracture is still controversial. The use of subcutaneous fasciotomy is useful in the medically unstable patient in whom long-term results may be a moot point. Limited fasciectomy is preferred over radical excision as a simpler operation and because of fewer complications. Wound closure is still a major point of contention. A prospective, randomized study of open wounds versus skin grafts versus closed procedures is needed to give more information regarding the long-term results. Currently, at our institution, we perform limited fasciectomy and leave the palm open. Early and aggressive mobilization is thought to be the key to good results.