Abstract
Though open surgical fasciotomy was one of the earliest described treatments for Dupuytren contracture, little has been written on this treatment method. Open fasciotomy is an attractive treatment method for Dupuytren contracture, as it requires much less extensive dissection than fasciectomy. Additionally, it may be associated with less risk to neurovascular structures than percutaneous needle aponeurotomy, in which the neurovascular structures are not visualized. Recurrence rates for open fasciotomy requiring revision surgery are higher than fasciectomy and likely similar to percutaneous needle aponeurotomy, though future study is needed on this topic. Open fasciotomy wounds reliably heal by secondary intention with minimal reported complications. Results of open fasciotomy are optimized in patients with isolated or predominant metacarpophalangeal joint contractures. Contractures at the proximal and distal interphalangeal joints are less reliably managed with open fasciotomy.
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Suggested Readings
Bryan AS, Ghorbal MS. The long-term results of closed palmar fasciotomy in the management of Dupuytren’s contracture. J Hand Surg (Edinburgh, Scotland). 1988;13(3):254–6.
Colville J. Dupuytren’s contracture—the role of fasciotomy. Hand. 1983;15(2):162–6.
Dupuytren G. Permanent retraction of the fingers, produced by an affection of the palmar fascia. Lancet. 1834;2:222–5.
Rowley DI, Couch M, Chesney RB, Norris SH. Assessment of percutaneous fasciotomy in the management of Dupuytren’s contracture. J Hand Surg (Edinburgh, Scotland). 1984;9(2):163–4.
Stewart C, Davidson D, Hooper G. Re-operation after open fasciotomy for Dupuytren’s disease in a series of 1077 consecutive operations. J Hand Surg Eur Vol. 2013;39(5):553–4.
Acknowledgement
The authors would like to thank Dr. Richard Kang, MD, for use of the photos appearing in this case.
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Draeger, R.W., Stern, P.J. (2016). Surgical Fasciotomy for Dupuytren Contracture. In: Rizzo, M. (eds) Dupuytren’s Contracture. Springer, Cham. https://doi.org/10.1007/978-3-319-23841-8_7
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DOI: https://doi.org/10.1007/978-3-319-23841-8_7
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