Treatment of stages III-IV of the Dupuytren's disease using a personal approach: percutaneous needle fasciotomy (PNF) and minimal invasive selective aponeurectomy

AbstractThe authors present their experience in treating 23 fingers on 20 patients affected by Dupuytrens Disease in stages III and IV of the Tubiana classification with their personal technique that involves the percutaneous needle fasciotomy followed 40 days after by a selective open aponeurectomy on the previously treated cord, by making a small cutaneous incision. The treatment requires careful selection of the patients. In fact, patients suffering from the disease for more than 5 years and all the cases with a suspicion of joint rigidity are excluded from the study. The average follow up period was approximately 48 months. 18 out of the 20 patients had excellent functional recovery. Skin grafts or local flaps are not required after selective aponeurectomy with these surgical steps. The advantages of this technique include its simplicity, minimal discomfort to patients, rapid functional recovery, low recurrence rate and low cost.