Skip to main content
SpringerLink
Log in

Treatment of Dupuytren’s Contracture with Dermofasciectomy

  • Chapter
  • First Online:
Dupuytren’s Contracture

  • 702 Accesses

Abstract

The use of a full thickness skin graft to cover a palmar defect remaining after surgical excision of diseased Dupuytren’s tissue, also known as dermofasciectomy, has been employed for both management of diffuse and recurrent disease. Heuston was one of the first authors to describe management of recurrent Dupuytren’s in the 1960s (Hueston, PlasReconstr Surg 31:66–69, 1963). His classic article notes a clear distinction between recurrence at the primary surgical location and extension into the surrounding tissue. This chapter offers the example of a 59-year-old right hand dominant male as an illustrative case of management with dermofasciectomy of recurrent Dupuytren’s disease following previous fasciectomy. A full thickness skin graft was harvested from the hairless surface of the medial brachium of the ipsilateral arm and sutured in place in the distal left palm where the recurrent disease had been excised. Three-month follow-up demonstrated improved strength, motion, and return to recreational golf. Final follow-up was 3 years post skin graft with no evidence of disease recurrence in the distal left palm.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Moermans JP. Segmental aponeurectomy in Dupuytren’s disease. J Hand Surg Br. 1991;16B:243–54.

    Article  Google Scholar 

  2. Moermans JP. Long-term results after segmental aponeurectomy for Dupuytren’s disease. J Hand Surg Br. 1996;21:797–800.

    Article  CAS  PubMed  Google Scholar 

  3. McCash CR. The open palm technique in Dupuytren’s contracture. J Plast Surg Br. 1964;17:271–80.

    Article  CAS  Google Scholar 

  4. Denkler KA. Collagenase for recurrent dupuytren contracture with skin grafts. J Hand Surg Am. 2013;38(6):1264.

    Article  PubMed  Google Scholar 

  5. Zhang AY, Curtin CM, Hentz VR. Flexor tendon rupture after collagenase injection for Dupuytren contracture: case report. J Hand Surg Am. 2011;36(8):1323–5.

    Article  PubMed  Google Scholar 

  6. Peimer CA, et al. Dupuytren contracture recurrence following treatment with collagenase Clostridium histolyticum (CORDLESS Study): 3-year data. J Hand Surg Am. 2013;38(1):12–22.

    Article  PubMed  Google Scholar 

  7. Chen NC, Shauver MJ, Chung KC. Cost-effectiveness of open partial fasciectomy, needle aponeurotomy, and collagenase injection for Dupuytren’s contracture. J Hand Surg Am. 2011;36A:1826–34.

    Article  Google Scholar 

  8. Eaton C. Percutaneous fasciotomy for Dupuytren’s contracture. J Hand Surg Am. 2011;36A:910–5.

    Article  Google Scholar 

  9. van Rijssen AL, Werker PMN. Percutaneous needle fasciotomy for recurrent Dupuytren disease. J Hand Surg Am. 2012;37A:1820–3.

    Article  Google Scholar 

  10. Shin EK, Jones NF. Minimally invasive technique for release of Dupuytren’s contracture: segmental fasciectomy through multiple transverse incisions. Hand. 2011;6:256–9.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Skoog T. Dupuytren’s contracture: pathogenesis and surgical treatment. Surg Clin North Am. 1967;47(2):433–44.

    Article  CAS  PubMed  Google Scholar 

  12. Henry M. Dupuytren’s disease: current state of the art. Hand. 2014;9:1–8.

    Article  PubMed  Google Scholar 

  13. Denkler K. Surgical complications associated with fasciectomy for Dupuytren’s disease: a 20-year review of the English literature. J Plast Surg. 2010;10:116–33.

    Google Scholar 

  14. Dias JJ, Braybrooke J. Dupuytren’s contracture: an audit of the outcomes of surgery. J Hand Surg (Br). 2006;31(5):514–21.

    Article  CAS  Google Scholar 

  15. Rizzo M, Stern PJ, Benhaim P, Hurst LC. Contemporary management of Dupuytren contracture. Instr Course Lect. 2014;63:131–42.

    PubMed  Google Scholar 

  16. Becker GW, Davis TR. The outcome of surgical treatments for primary Dupuytren’s disease—a systematic review. J Hand Surg Eur. 2010;35(8):623–6.

    Article  CAS  Google Scholar 

  17. Gordon S. Dupuytren’s contracture: recurrence and extension following surgical treatment. Br J Plast Surg. 1957;9:286–8.

    Article  CAS  PubMed  Google Scholar 

  18. Hueston JT. Digital Wolfe grafts in recurrent Dupuytren’s contracture. Plast Reconstr Surg. 1962;29:342–4.

    Article  CAS  Google Scholar 

  19. Ketchum LD, Hixson FP. Dermofasciectomy and full-thickness grafts in the treatment of Dupuytren’s contracture. J Hand Surg. 1987;12A:659–63.

    Article  Google Scholar 

  20. Varian JPW. Full thickness skin grafts in the management of recurrent Dupuytren’s disease. In: Hueston JT, Tubiana R, editors. Dupuytren’s disease. 2nd ed. London: Churchill Livingstone; 1985. p. 154–7.

    Google Scholar 

  21. Armstrong JR, Jurren JS, Logan AM. Dermofasciectomy in the management of Dupuytren’s disease. J Bone Joint Surg [Br]. 2000;82-B:90–4.

    Article  Google Scholar 

  22. Abe Y, Rokkaku T, Ofuchi S, et al. An objective method to evaluate the risk of recurrence and extension of Dupuytren’s disease. J Hand Surg Br. 2004;29B:427–30.

    Article  Google Scholar 

  23. Tubiana R. Surgical indications. In: Tubiana R, Leclercq C, Hurst LC, Badalamente MA, Mackin EJ, editors. Dupuytren’s disease. London: Martin Dunitz; 2000. p. 218–22.

    Google Scholar 

  24. Anwar MU, Al Ghazal SK, Boome RS. The lateral digital flap for Dupuytren's fasciectomy at the proximal interphalangeal joint—a study of 84 consecutive patients. J Hand Surg (Eur). 2009;34E(1):90–3.

    Article  Google Scholar 

  25. Hueston JT. Skin replacement in Dupuytren’s contracture. In: Hueston JT, Tubiana R, editors. Dupuytren’s disease. Edinburgh: Churchill Livingstone; 1974. p. 119–22.

    Google Scholar 

  26. Brotherston TM, Balakrishnan C, Milner RH, Brown HG. Long term follow-up of dermofasciectomy for Dupuytren’s contracture. Br J Plast Surg. 1994;47:440–3.

    Article  CAS  PubMed  Google Scholar 

  27. Hall PN, Fitzgerald A, Sterne GD, Logan AM. Skin replacement in Dupuytren’s disease. J Hand Surg. 1997;22-B:193–7.

    Article  Google Scholar 

  28. Roy N, Sharma D, Mirza A, Fahmy N. Fasciectomy and full thickness skin grafting in Dupuytren’s contracture. The fish technique. Acta Orthop Belg. 2006;72:678–82.

    PubMed  Google Scholar 

  29. Tonkin MA, Burke FD, Varian JPW. Dupuytren's contractures: a comparative study of fasciectomy and dermofasciectomy in one hundred patients. J Hand Surg Br. 1984;9B:156–62.

    Article  Google Scholar 

  30. Roush RF, Stern PJ. Results following surgery for recurrent Dupuytren’s disease. J Hand Surg. 2000;25A:291–6.

    Article  Google Scholar 

  31. Ullah AS, Dias JJ, Bhowal B. Does a ‘firebreak’ full-thickness skin graft prevent recurrence after surgery for Dupuytren’s contracture? J Bone Joint Surg Br. 2009;91-B:374–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, UPMC-Hamot, 201 State Street, Erie, PA, 16550, USA

    Nathan A. Monaco MD, C. Liam Dwyer MD & John D. Lubahn MD

Authors
  1. Nathan A. Monaco MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Liam Dwyer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John D. Lubahn MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nathan A. Monaco MD .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery Division of Hand Surgery, Mayo Clinic, Rochester, Minnesota, USA

    Marco Rizzo

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Monaco, N.A., Dwyer, C.L., Lubahn, J.D. (2016). Treatment of Dupuytren’s Contracture with Dermofasciectomy. In: Rizzo, M. (eds) Dupuytren’s Contracture. Springer, Cham. https://doi.org/10.1007/978-3-319-23841-8_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-23841-8_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23840-1

  • Online ISBN: 978-3-319-23841-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation