Needle fasciotomy for Dupuytren’s contracture- a prospective cohort study of 58 fingers with a median follow-up of 6.5 years

Abstract

Needle fasciotomy (NF) is a minimally invasive treatment option for Dupuytren contractures, but long-term results have indicated a high recurrence rate. This prospective study was initiated to monitor the introduction of NF in a context where limited fasciectomy had been the only treatment option, and to investigate the long-term results. The inclusion criterion was a palpable cord with a Metacarpophalangeal (MCP) and/or Proximal interphalangeal (PIP) contracture in one or more fingers. Fifty-eight fingers in 42 patients (40 male and 2 female with a median age of 68 years) were treated by needle fasciotomy between November 2010 and March 2012, and were followed for a median of 6.5 years. The median total passive extension deficit (TPED) was 52° at baseline, but decreased significantly to 20° postoperatively. No severe adverse events such as nerve or tendon injuries were reported. At final-follow up of 48 fingers the median TPED was still significantly reduced to 23° for all fingers (p < 0.0001). Twenty-nine fingers retained full correction of the contracture, and in patients with recurrent contractures NF was preferred in 13 out of 17 patients. This study showed that needle fasciotomy is a safe procedure for Dupuytren’s contracture, with excellent immediate reduction of the joint contracture and with a recurrence rate comparable to treatment by collagenase clostridium histolyticum (CCH).

Keywords:

• Dupuytren’s disease
• Dupuytren cord
• percutaneous needle fasciotomy
• needle aponeurotomy

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This investigation conforms with the University of Gothenburg Human Resource Protection Program guidelines. Funding for this project was provided by Sahlgrenska University Hospital and the University of Gothenburg, Sweden. The authors would like to thank physiotherapist Marie Medbo for the follow up at one year, and Lena Nyblom-Andersson for administration of patient data and logistics for the study.