Percutaneous Dupuytren's Contracture release

Percutaneous Needle Aponeurotomy for Dupuytren's Contracture ~ Houston Plastic Surgeons

• Percutaneous needle aponeurotomy is a minimally invasive procedure for release of Dupuytren's contracture by dividing the cords percutaneously using a needle.
• A study conducted involving 3736 procedures using this technique reported good results (>70% correction) in 81% of patients
• Complication rates ranges from 3.7 to 8.9% which include nerve injury
• Another study involving 82 patients with 10 year follow-up showed that 2/3 of patients requiring a second release within 5 years
• Recurrence rates of  Dupuytren's contracture after limited local excision ranges from 34 to 66%
• Recurrence rates after extensive excision of the palmar aponeurosis is 11.6%
• Typical recurrence rate after needle aponeurotomy is ~50% in 3-5 years
• Not all patients are candidates for percutaneous needle aponeurotomy
• Long term correction is better maintained in the metcarpophalangeal joint (knuckle joint) than the proximal interphalangeal joint of the finger (70 vs 41%).

I recommend asking your hand surgeon if he/she performs this kind of procedure.  Not all patients are candidates for percutaneous needle aponeurotomy for Dupuytren's contracture.  

Emmanuel De La Cruz M.D.

Reference:

Cheng et al. Needle Aponeurotomy for Dupuytren's Contracture. Journal of Orthopedic Surgery. 2008; 16 (1):88-90

Duthie RA, Chesney RB. Percutaneous fasciotomy for Dupuytren’s contracture. A 10-year review. J hand Surg Br 1997;22:521–2.

Badois F. Non-surgical treatment of Dupuytren’s contracture. Available from: http://assoc.wanadoo.fr/f.badois-dupuytren/html/gbsommaire.html. Accessed 4 December 2006.