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Minimally Invasive Partial Fasciectomy

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Dupuytren’s Contracture

Abstract

A 76-year-old male with Dupuytren’s disease isolated to the right fourth digit presented with an MCP contracture of 40° and PIP contracture of 80°. As the patient experienced daily hand dysfunction, he was interested in pursuing intervention. After discussion of options, the patient opted for minimally invasive partial fasciectomy. This technique utilizes multiple transverse incisions to excise segments of diseased tissue. By reducing the degree of tissue dissection, patients experience quicker recovery with acceptable outcomes, especially those without significant PIP joint involvement.

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References

  1. Black EM, Blazer PE. Dupuytren disease: an evolving understanding of an age-old disease. J Am Acad Orthop Surg. 2011;19:746–57.

    Article  PubMed  Google Scholar 

  2. Coert JH, Barret JP, Meek MF. Results of partial fasciectomy for Dupuytren disease in 261 consecutive patients. Ann Plast Surg. 2006;57:13–7.

    Article  CAS  PubMed  Google Scholar 

  3. Dolmans GH, Werker PM, Hennies HC, et al. Wnt signaling and Dupuytren’s disease. N Engl J Med. 2011;365:307–17.

    Article  CAS  PubMed  Google Scholar 

  4. Murrell GA, Francis MJ, Howlett CR. Dupuytren’s contracture: fine structure in relation to aetiology. J Bone Joint Surg Br. 1989;71(3):367–73.

    CAS  PubMed  Google Scholar 

  5. Burke FD, Proud G, Lawson IJ, McGoech KL, Miles JN. An assessment of the effects of exposure to vibration, smoking, alcohol and diabetes on the prevalence of Dupuytren’s disease in 97,537 miners. J Hand Surg Eur. 2007;32(4):400–6.

    Article  CAS  Google Scholar 

  6. Burge P, Hoy G, Regan P, Milne R. Smoking, alcohol and the risk of Dupuytren’s contracture. J Bone Joint Surg Br. 1997;79(2):206–10.

    Article  CAS  PubMed  Google Scholar 

  7. Pess GM, Pess RM, Pess RA. Results of needle aponeurotomy for Dupuytren contracture in over 1,000 fingers. J Hand Surg Am. 2012;37A:351–6.

    Google Scholar 

  8. Glickel SZ. Update on surgery of the hand. J Am Acad Orthop Surg. 2013;21(4):202–3.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  10. Gelman S, Schlenker R, Bachoura A, Jacoby SM, Lipman J, Shin EK, Culp RW. Minimally invasive partial fasciectomy for Dupuytren’s contractures. Hand. 2012;7:364–9.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Srinivasan RC, Shah SH, Jebson PJ. New treatment options for Dupuytren’s surgery: collagenase and percutaneous aponeurotomy. J Hand Surg Am. 2010;35:1362–4.

    Article  PubMed  Google Scholar 

  12. Chen NC, Srinivasan RC, Shauver MJ, Chung KC. A systematic review of outcomes of fasciotomy, aponeurotomy, and collagenase treatments for Dupuytren’s contracture. Hand. 2011;6:250–5.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Baltzer H, Binhammer PA. Cost-effectiveness in the management of Dupuytren’s contracture. A Canadian cost-utility analysis of current and future management strategies. Bone Joint J. 2013;95B(8):1094–100.

    Article  Google Scholar 

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

    Article  Google Scholar 

  15. Lee H, Eo S, Cho S, Jones NF. The surgical release of Dupuytren’s contracture using multiple transverse incisions. Arch Plast Surg. 2012;39(4):426–30.

    Article  PubMed  PubMed Central  Google Scholar 

  16. 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 

  17. Tonkin MA, Burke FD, Varian JP. Dupuytren’s contracture: a comparative study of fasciectomy and dermatofasciectomy. J Hand Surg Br. 1984;9:156–62.

    Article  CAS  PubMed  Google Scholar 

  18. Chick LR, Lister GD. Surgical alternatives in Dupuytren’s contracture. Hand Clin. 1991;7(4):715–9.

    CAS  PubMed  Google Scholar 

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

    Article  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  21. 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 

  22. Citron N, Hearnden A. Skin tension in the aetiology of Dupuytren’s disease: a prospective trial. J Hand Surg Br. 2003;28:528–30.

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  24. Watt AJ, Curtin CM, Hentz VR. Collagenase injection as nonsurgical treatment of Dupuytren’s disease: 8-year follow-up. J Hand Surg Am. 2010;35:534–9.

    Article  PubMed  Google Scholar 

  25. Canadian Agency for Drugs and Technologies in Health. Needle or open fasciotomy for Dupuytren’s contracture: a review of the comparative efficacy, safety and cost-effectiveness—an update. Rapid response report: summary with critical appraisal. November 11, 2013.

    Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  27. Freehafer AA, Strong JM. The treatment of Dupuytren’s contracture by partial fasciectomy. J Bone Joint Surg. 1963;45A(6):1207–16.

    Google Scholar 

  28. Anwar MU, Al Ghazal SK, Boome RS. Results of surgical treatment of Dupuytren’s disease in women: a review of 109 consecutive patients. J Hand Surg Am. 2007;32:1423–8.

    Article  CAS  PubMed  Google Scholar 

  29. Misra A, Jain A, Ghazanfar R, Johnston T, Nanchahal J. Predicting the outcome of surgery for the proximal interphalangeal joint in Dupuytren’s disease. J Hand Surg. 2007;32A:240–5.

    Article  Google Scholar 

  30. Denkler K. Surgical complications associated with fasciectomy for Dupuytren’s disease: a 20-year review of the English literature. Eplasty. 2010;10:e15.

    PubMed  PubMed Central  Google Scholar 

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Correspondence to Justin D. Stull BA .

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© 2016 Springer International Publishing Switzerland

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Jacoby, S.M., Stull, J.D. (2016). Minimally Invasive Partial Fasciectomy. In: Rizzo, M. (eds) Dupuytren’s Contracture. Springer, Cham. https://doi.org/10.1007/978-3-319-23841-8_6

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  • DOI: https://doi.org/10.1007/978-3-319-23841-8_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23840-1

  • Online ISBN: 978-3-319-23841-8

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