Partial Fasciectomy for Dupuytren’s Contractures

One hundred ninety-six patients with Dupuytren’s contractures were treated by partial fasciectomy and adequate postoperative rehabilitation. All patients had flexion contracture of the proximal interphalangeal joint of >20°; 93 patients had flexion contracture of the associated metacarpophalangeal joint of >30°; 143 patients had risk factors for Dupuytren’s disease. Primary skin closure and splinting were done in all patients. Range of motion was begun by the 1st week. Splinting was discontinued by the and week, followed by night-time splinting until the 8th week. The mean follow-up was 6.6 years (range, 2–9 years). At the latest examination, 72.5% of the patients had complete range of motion of the metacarpophalangeal and proximal interphalangeal joints; 20.2% had 5° –10° of extension deficit and 7.3% had recurrent contractures of >20° at the proximal interphalangeal joint and were subjected to reoperation. Complications included digital neurovascular injury in 5%, complex regional pain syndrome in 10.1%, and wound-healing problems and superficial infections in 15.1%. (Journal of Surgical Orthopaedic Advances 18(2):106–110, 2009)