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Dupuytren's fasciectomy

Surgeon-side topic for dupuytren's fasciectomy. Backed by 317 articles from the corpus, retrieved via combined MeSH + title-text matching.

70 citationsUpdated Sep 2026
Illustration: Dupuytren's fasciectomy

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Overview

Surgery remains the gold-standard treatment for progressive Dupuytren contractures, with limited palmar fasciectomy being the most common option [6]. Between 2003 and 2008, fasciectomy was the most common surgical procedure for Dupuytren's contracture in England [7]. Although there has been a marked shift from inpatient to day-case procedures in England, likely due to economic trends and healthcare system changes [7], treatment of Dupuytren disease has shifted from open fasciectomy to collagenase injections, which accounted for 61% of treatments by 2021 [25]. Currently, there remains limited evidence to guide the management of patients with Dupuytren's contracture [16], and little agreement exists on treatment recommendations for common presentations among international hand surgeons [11].

Surgical intervention for Dupuytren contractures achieves a high rate of full or almost full correction (75%) [8]. Patients gain a significant functional benefit following surgical improvement or correction of the deformity [3], and hand normality improved after surgery for Dupuytren disease [2]. In the long term, limited fasciectomy is currently the most reliable treatment for Dupuytren's contracture, but the risk for complications is significant [13]. Dermofasciectomy appears to be a highly effective surgical intervention for advanced Dupuytren disease, offering substantial long-term benefits in terms of function and disease control [9]. Repeat limited fasciectomy in selected patients is an effective treatment for patients with recurrence of Dupuytren's disease, successfully correcting flexion contracture and improving range of motion which was maintained at five-year follow-up [21].

Outcomes from therapeutic interventions for pre-operative management of Dupuytren's Disease were largely positive [14]. Perioperative corticosteroid administration appears to be safe and improves early range of motion and DASH scores following Dupuytren's fasciectomy [4]. Long-term overall reintervention and perceived recurrence following treatment of Dupuytren contracture affecting a single digit were higher with CCH treatment than surgical fasciectomy when comparing groups with similar baseline characteristics [12]. In patients with Dupuytren disease, collagenase injection and surgical fasciectomy improved finger joint contracture over the pretreatment status but had a high prevalence of joint contracture in the treated fingers 5 years after treatment [10]. There is low level of evidence that both surgical and nonsurgical treatments provide clinically important improvements for recurrent Dupuytren contracture [23].

Anatomy & Pathophysiology

Disease Definition and Etiology

Dupuytren’s disease is a progressive fibroproliferative disorder of the palmar fascia that leads to flexion contractures impairing hand function [97]. The condition is characterized by pitting and thickening of the palmar fascia, which can be complicated by the development of a cord extending into the affected fingers [84]. This progression results in a progressive digital flexion contracture of the metacarpophalangeal joint and interphalangeal joint [84]. The precise aetiology of Dupuytren’s disease is poorly understood [84]. Genetic predisposition plays a primary role in the disease, with emerging evidence implicating mechanical stress and trauma as potential contributing factors [97]. Repetitive strain or trauma to the palmar fascia may disrupt normal tissue homeostasis, triggering an exaggerated fibrotic response that promotes disease progression [97].

Cellular and Molecular Pathophysiology

At the cellular level, Dupuytren’s disease is characterized by excessive extracellular matrix deposition driven by aberrant myofibroblast activity [97]. Transforming growth factor-beta is a key regulator of myofibroblast differentiation in the disease process [97], while tumour necrosis factor drives persistent fibrosis by dysregulating extracellular matrix turnover [97]. Aberrant tumour necrosis factor and transforming growth factor-beta signalling pathways contribute to persistent fibrosis in Dupuytren’s disease [97]. Myofibroblasts contribute to a self-sustaining fibrotic process in a predisposed extracellular matrix environment rather than initiating the disease [97]. This fibrotic process leads to fascia thickening, nodule formation, and pathological cords that cause contractures [97].

Palmar Fascia Anatomy

The superficial palmar fascia lies in a coronal plane beneath the palmar subcutaneous tissue [72]. It covers a triangular area of the central palm with the proximal corner facing directly proximal [72]. When present, the palmaris longus tendon terminates in continuity with the fibers of the proximal corner of the superficial palmar fascia [72]. Four central bands of fascia extend distally from the proximal corner toward each of the fingers, with no central band for the thumb [72]. The central bands separate and diverge just distal to the transverse retinacular ligament, each following the underlying ray [72]. At the distal palmar crease level, the central bands are bridged transversely by the superficial transverse palmar ligament [72]. Fibers from the central bands pass above, below, and through the superficial transverse palmar ligament [72].

Fiber Group Involvement: * Superficial fibers: Stay superficial and merge with vertical retinacular fibers at the dermis’s undersurface in the distal palm [72]. These superficial subcutaneous fibers are more often involved with nodules than other fiber groups [72]. * Intermediate fibers: Split transversely into two sections extending toward the lateral border of the digit base, forming the spiral band that tracks around the neurovascular bundle [72]. Spiral neurovascular bundles develop when spiral bands shorten [72]. * Deep fibers: Continue dorsally to merge with sagittal interosseous fascia fibers and pierce the transverse deep intermetacarpal ligament to merge with fibers of the sagittal bands of the extensor mechanism [72]. Deep fibers are rarely involved in contractures [72].

Digital and Web Space Anatomy

Digital neurovascular structures are surrounded by a diffuse network of thin transverse oblique fibers [72]. Fibers dorsal to the neurovascular bundle are collectively called Cleland ligament, while those palmar to the bundle are called Grayson ligament [72]. Undisturbed, these "ligaments" are a mesh of nonparallel individual fibers, and the appearance of a ligament is a dissection artifact from releasing skin attachments [72]. These fibers have a common origin in continuity with the fingers’ retinacular ligaments, the floor of the flexor tendon sheath, and retinacular fibers attaching the palmar digital skin to deeper structures [72]. On the small finger’s ulnar border, lateral fascial attachments are in continuity with the abductor digiti minimi fascia and tendon [72].

A subdermal fascial layer borders the periphery of the web spaces from roughly the radial thumb sesamoid to the ulnar side of the small finger’s proximal flexion crease [72]. Border fibers form the distal first web space ligament between thumb and index in continuity with the natatory ligament that spans the remaining web spaces [72]. Fibers from the natatory ligament extend distally at each finger’s lateral base in continuity with Grayson ligament fibers and the lateral digit dermis [72].

Secondary Pathologies and Functional Impact

Long-standing proximal interphalangeal joint contracture in Dupuytren disease can lead to central slip attenuation and resultant imbalances in the extensor mechanism [105]. Prolonged flexion contracture of the proximal interphalangeal joint can result in pseudo-boutonniere deformity [105]. Secondary pathologies from long-standing primary Dupuytren contractures include mallet deformities, sagittal band rupture, and boutonniere deformity [105]. Imbalances of the extensor mechanism are caused by Dupuytren's disease [93]. Palmar skin elasticity is decreased in mild Dupuytren’s disease compared to healthy controls [126]. Dynamism is common in Dupuytren's contractures and may be a source of error or bias in trials using angular deformity as an endpoint [125].

Classification

There is a lack of standardization in the recording of data for Dupuytren's disease, making critical comparison of techniques or results impossible due to major inconsistencies in reporting [29]. Dupuytren staging can be conceptualized in three terms: assessment, scoring system, and classification [35].

Assessment: Assessment is defined as an aspect that might be measured, such as degree of contracture or type of disease [35]. Methods of assessment used in the study of Dupuytren disease include degree of contracture or range of motion [35]. They also include disease type based on the localization of pathologic fascia [35], histology [35], and Dupuytren diathesis, characterized by bilateral disease, family history of Dupuytren, ectopic lesions, and young age at onset of disease [35]. Further assessment methods include hand function or disability measured by the Unite Rhumatologique des Affections de la Main (URAM), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and Michigan Hand Questionnaire (MHQ) [35]. Additional metrics include rate of recovery or time to return to work [35], recurrence and progression [35], and complications [35].

Scoring System: A scoring system is defined as a system that attempts to quantify the disease by producing a series of numbers or discrete variables [35]. Scoring systems for Dupuytren disease fall into five proposed categories [35]. One category of scoring system is severity according to degree of contracture [35]. Another category involves detailed scoring of every digit [35]. A third category scores the severity of the condition or results of surgery into arbitrary categories of excellent, good, fair, or poor [35].

Classification: Classification is defined as subdivisions into types that are not ordinal [35]. The Tubiana classification was used to grade patients in a randomized clinical trial comparing Bruner and McCash incisions for limited fasciectomy [110].

Clinical Presentation

Clinically significant Dupuytren's disease is prevalent in the general population, with the majority of diagnosed individuals proceeding to treatment [36]. The primary motivation for patients seeking intervention is the potential to regain hand function [79]. While the disease is progressive, the pace of progression is unique to each patient, and it may remain non-progressive without developing contracture; two case reports document individuals with palm thickening but no functional impairment over 20 to 30 years [55]. Dupuytren disease must be included in the differential diagnosis for nodules in the palm or fingers, or finger contractures, in children [54].

Diagnostic and Assessment Considerations: * Outcome Reporting: There is currently no recommended standard set of outcomes for Dupuytren’s disease studies, nor are there guidelines on how to report these outcomes [79]. This heterogeneity makes it difficult to compare studies by pooling individual results in systematic reviews or meta-analyses [79]. * Patient Satisfaction: Assessing domains relating to patient satisfaction beyond objective hand function measures is important [51]. * Hand Normality Score: Hand normality improved after surgery and performed favorably compared with preexisting outcome measures, suggesting it may be a useful adjunct to gauge surgical success [2].

Surgical and Pathological Context: * Recurrence Histology: Recurrent Dupuytren's disease after fasciectomy and collagenase Clostridium histolyticum are histologically indistinguishable [19]. * Salvage Procedures: Proximal interphalangeal joint arthrodesis combined with needle fasciotomy or segmental fasciectomy provides a satisfactory salvage procedure for severe recurrent Dupuytren's disease [42]. * Severe PIPJ Contracture: A simple staged procedure using a central slip facilitation device is a valid alternative for severe Dupuytren's PIPJ contracture, demonstrating reliable, reproducible correction and acceptable patient outcomes [15]. * Limited Fasciectomy: This procedure requires special attention during surgery and rehabilitation [24]. * CRPS Recognition: Use of a Budapest criteria checklist may guide documentation and speed recognition for an earlier diagnosis of CRPS in patients with Dupuytren's and an atypical post-fasciectomy response [26].

Atypical Presentations and Controversies: * Skin Involvement: One case demonstrates Dupuytren fibromatosis invading a full-thickness skin graft, suggesting the burden of skin disease may be greater than currently perceived and raising questions about the pathophysiology of recurrence [40]. * Radial-Sided Disease: Another case report explores the anatomic basis and surgical management of radial-sided Dupuytren disease via the unusual presence of a distinct 'lambda' cord of the thumb [56]. * Treatment Consensus: Little agreement exists on treatment recommendations for common presentations among international hand surgeons [11]. Recommendations vary throughout the world, relating to patient preference and surgeon expertise [88]. Guidelines for adequate treatment of each stage of Dupuytren's disease are still lacking [88]. The best treatment for Dupuytren contractures continues to be fiercely debated, and while the disease is progressive, best treatments remain uncertain [38].

Investigations

Clinical Assessment and Classification

Standardized data recording for Dupuytren’s disease is lacking, creating major inconsistencies that render critical comparison of techniques or results impossible [29]. A systematic approach to the physical examination of the hand and wrist is essential to pinpoint or narrow the scope of possible pathologic processes [44]. While diagnostic tests such as imaging and serum laboratory studies are useful, they can be expensive, time-consuming, and often nonspecific; therefore, a careful physical examination remains essential to direct care [44]. Surgical correction of the deformity provides significant functional benefit to patients [3]. Additionally, a self-perceived hand normality score improved after surgery and performed favorably compared with preexisting outcome measures [2].

Imaging

Doppler: An 8-MHz Doppler tone assessment may identify superficially displaced neurovascular bundles when Dupuytren cords lie beneath soft fleshy prominences, though false-negatives are possible [75]. Doppler imaging represents a promising improvement for identifying palmar structures, but higher resolution imaging technology is required [75].

MRI: MR assessment of Dupuytren’s disease is hindered by the resolution of current equipment, orientation issues due to multiplanar deformities of the fingers, and lack of intraoperative availability [75]. MRI is probably most useful in identifying additional pathology such as flexor tendon bowstringing [75]. It may also provide a quantitative noninvasive measure of cellularity in affected areas, serving as an index of biologic activity; however, this potential staging tool has not been investigated yet on a large scale [75].

Ultrasound: The intraobserver reliability of sonographic assessment of Dupuytren disease nodules is good, with area measurement being the most reliable metric [130].

Pathology

Dupuytren fibromatosis can invade a full-thickness skin graft, suggesting the burden of skin disease may be greater than currently perceived [40].

Treatment

Non-Operative

The provided evidence does not detail specific conservative management protocols such as weight loss, physical therapy, or NSAIDs. However, hand surgeons are advised to remain well-informed about current evidence-based practices, including nonsurgical methods for treating Dupuytren disease [17].

Operative

Indications: Surgical intervention is usually considered when metacarpophalangeal (MP) contracture is ≥30° or when there is any degree of proximal interphalangeal (PIP) joint contracture [104]. The longer the deformity is allowed to progress, the greater the chance of contracture becoming irreversible, especially for PIP contractures which are often treated earlier and more aggressively [104].

Surgical Approach / Technique: Limited fasciectomy is currently the most reliable treatment for Dupuytren's contracture, though the risk for complications is significant [13]. Open subtotal fasciectomy remains the most commonly reported procedure for the PIP joint [103]. The modified McCash technique is a reliable and important technique for managing Dupuytren disease, offering contracture release with minimal dissection, decreased postoperative pain, and reduced risk of contracture and hematoma formation [52]. For residual PIP flexion contracture, there is no consensus on whether further intra-operative surgical manoeuvres help [103]; however, a simple release of the flexor tendon sheath alone can frequently correct residual fixed flexion contracture after subtotal fasciectomy [103].

Percutaneous and Minimally Invasive Techniques: Percutaneous needle fasciotomy is safe and reliable even in patients with advanced Dupuytren disease, resulting in predictably acceptable outcome with low risk of complications [20]. Needle aponeurotomy is a minimally invasive technique performed under local anesthesia and does not typically require formal postoperative hand therapy [104]. Although a common procedure in France, a US survey estimates about 12 % of patients receive needle aponeurotomy [104]. A refinement of the earlier method of percutaneous fasciotomy is considered a useful and safe technique in the surgical armamentarium for the treatment of Dupuytren disease [5].

Comparative Outcomes: At 3 months and 1 year, the outcomes of needle fasciotomy and collagenase injection are the same in Dupuytren's disease with predominantly metacarpophalangeal joint involvement [31]. At 3 months, needle fasciotomy and collagenase injection were not different in correction of finger contracture in Dupuytren's disease, with minor complications [34].

Setting of Care: A fasciectomy performed under local anaesthetic with adrenaline and without an arm tourniquet in a community setting is safe and results in favourable outcomes regarding the degree of correction of contracture achieved, functional scores, and short-term complications [115]. Between 2003 and 2008, fasciectomy was the most common surgical procedure for Dupuytren's contracture in England, with a marked shift from inpatient to day-case procedures likely due to economic trends and healthcare system changes [7].

Adjuncts: Patients solely undergoing surgical release of their trigger finger had significantly higher odds and expedited rate of developing new-onset Dupuytren disease overall and undergoing subsequent treatment by fasciectomy compared with trigger fingers managed by other interventions [1].

Revision: In patients with Dupuytren disease and severe PIP joint contracture after multiple treatments, a novel procedure consisting of middle-phalanx excision and ligament reconstruction creating a new functioning interphalangeal joint has good short-term outcomes and is a favorable alternative to finger amputation [124].

Other Considerations: There are several procedural options for the treatment of Dupuytren disease [22]. Hand normality improved after surgery for Dupuytren disease, and this score performed favorably compared with preexisting outcome measures [2].

Complications

Recurrence and Reintervention

Recurrence after Dupuytren contracture treatment is common in prospectively collected cohorts with a mean follow-up of 3.8 years [134]. Fasciectomy carries a high initial cost but demonstrates the lowest reintervention rate [138]. Approximately 10% of patients treated with collagenase injections underwent surgery within 5 years [135]. Mini-open partial fasciotomy for pretendinous contracture is a safe and effective treatment for MP and PIP joints, with only 1 in 5 joints undergoing repeat intervention within 5 years [139]. Percutaneous needle fasciotomy is effective for recurrent disease, with 50% of patients remaining free of recurrence for a mean of 4.4 years [92]. If a secondary recurrence occurs after percutaneous needle fasciotomy, it does so relatively early after treatment [92].

Surgical Complications and Safety

Many treatment options exist for Dupuytren contracture, each with its own complication profile [136]. For severe PIPJ contractures, major complications occurred at roughly half the rate in the staged group compared to single-stage fasciectomy, suggesting a potential safety advantage, although the study was underpowered for complication analysis [143]. The modified McCash technique offers contracture release with minimal dissection, decreased postoperative pain, and reduced risk of contracture and hematoma formation [52]. Hand normality improved after surgery for Dupuytren disease, and this score performed favorably compared with preexisting outcome measures, suggesting it may be a useful adjunct to gauge the success of surgery [2]. Dupuytren's disease in women presents similarly to men with more severe PIP joint involvement but equivalent surgical outcomes regarding final contracture correction, recurrence, and complication rates [142].

Alternative Techniques and Comparative Complications

The complication rate was low, but recurrences were frequent in younger patients and for PIP contractures following needle aponeurotomy [140]. Percutaneous needle aponeurotomy is an effective technique in the treatment of primary Dupuytren's disease, achieving near-complete correction of contractures with minimal complications [141]. No significant difference in recurrence rates between needle fasciotomy and collagenase injections three years after treatment of Dupuytren's contracture was found [27]. Collagenase injection and needle fasciotomy have similar 3-year recurrence rates in the treatment of Dupuytren's contracture [41]. This study revealed no significant difference between the results after collagenase injection and needle fasciotomy for MCP contracture secondary to Dupuytren contracture after 1 year [81]. The simple staged procedure is a valid alternative in the management of severe Dupuytren's PIPJ contracture, demonstrating reliable, reproducible correction of the deformity and acceptable patient outcomes [15].

Recovery

Functional Outcomes and Correction: Early postoperative outcomes indicate that microscopic fasciectomy may offer modest short-term advantages in maintaining correction, characterized by lower residual deformity and comparable functional outcomes [131]. This technique is associated with a relatively rapid learning curve [131]. Clinical results provide new information regarding activities that patients with Dupuytren's contracture experience as difficult to perform, describing positive changes in performance and range of motion [129].

Other Considerations: The lumbrical flexor (LF) in Dupuytren's disease requires special attention during surgery and rehabilitation [24].

Key Evidence

  • [L3] Patients solely undergoing surgical release of their trigger finger had significantly higher odds and expedited rate of developing new-onset Dupuytren disease overall and undergoing subsequent treatment by fasciectomy compared with trigger fingers managed by other interventions. [1] (10.1177/15589447221077375)
  • [L3] Hand normality improved after surgery for Dupuytren disease, and this score performed favorably compared with preexisting outcome measures, which suggests it may be a useful adjunct to gauge the success of surgery. [2] (10.1016/j.jhsa.2021.01.022)
  • [L3] Patients with Dupuytren's contracture of the hand gain a significant functional benefit following surgical improvement or correction of the deformity. [3] (10.1054/jhsb.2002.0776)
  • [L3] Perioperative corticosteroid administration appears to be safe and improves early range of motion and DASH scores following Dupuytren's fasciectomy. [4] (10.1177/15589447221084013)
  • [L4] The authors believe this refinement of the earlier method of percutaneous fasciotomy is a useful and safe technique in the surgical armamentarium for the treatment of Dupuytren disease. [5] (10.1016/j.jhsa.2013.08.087)
  • [L4] Surgery remains the gold-standard treatment for progressive Dupuytren contractures, with limited palmar fasciectomy being the most common option. [6] (10.1016/j.jhsa.2011.03.002)
  • [L4] Between 2003 and 2008, fasciectomy was the most common surgical procedure for Dupuytren's contracture in England, with a marked shift from inpatient to day-case procedures likely due to economic trends and healthcare system changes. [7] (10.1186/1471-2474-12-73)
  • [L5] Surgical intervention for Dupuytren contractures achieves a high rate of full or almost full correction (75%). [8] (10.1016/j.hcl.2018.04.002)
  • [L3] Dermofasciectomy appears to be a highly effective surgical intervention for advanced Dupuytren disease, offering substantial long-term benefits in terms of function and disease control. [9] (10.1016/j.jhsa.2025.02.007)
  • [L3] In patients with Dupuytren disease, collagenase injection and surgical fasciectomy improved finger joint contracture over the pretreatment status but had a high prevalence of joint contracture in the treated fingers 5 years after treatment. [10] (10.1016/j.jhsa.2022.04.019)
  • [L4] Little agreement exists on treatment recommendations for common presentations of Dupuytren disease in this sample of international hand surgeons. [11] (10.1016/j.jhsa.2017.08.023)
  • [L4] Long-term overall reintervention and perceived recurrence following treatment of Dupuytren contracture affecting a single digit were higher with CCH treatment than surgical fasciectomy when comparing groups with similar baseline characteristics. [12] (10.1016/j.jhsa.2021.05.022)
  • [L5] In the long term, limited fasciectomy is currently the most reliable treatment for Dupuytren's contracture, but the risk for complications is significant. [13] (10.1530/eor-23-0033)
  • [L1] Outcomes from therapeutic interventions for pre-operative management of Dupuytren's Disease were largely positive. [14] (10.1177/17589983241227162)
  • [L4] The simple staged procedure is a valid alternative in the management of severe Dupuytren's PIPJ contracture, demonstrating reliable, reproducible correction of the deformity and acceptable patient outcomes. [15] (10.1177/1753193412439673)
  • [L2] Currently there remains limited evidence to guide the management of patients with Dupuytren's contracture. [16] (10.1302/0301-620x.100b9.bjj-2017-1194.r2)
  • [L4] Hand surgeons continue to be well informed about current evidence-based practices for treating Dupuytren disease and can improve their knowledge by familiarizing themselves with current data on percutaneous and nonsurgical methods. [17] (10.1016/j.jhsg.2021.08.003)
  • [L3] Recurrent Dupuytren's disease after fasciectomy and collagenase Clostridium histolyticum are histologically indistinguishable. [19] (10.1177/1753193419900483)
  • [L4] Percutaneous needle fasciotomy is safe and reliable even in patients with advanced Dupuytren disease, resulting in predictably acceptable outcome with low risk of complications. [20] (10.1186/s13018-024-04844-3)
  • [L4] Repeat limited fasciectomy in selected patients is an effective treatment for patients with recurrence of Dupuytren's disease, successfully correcting flexion contracture and improving range of motion which was maintained at five-year follow-up. [21] (10.1302/0301-620x.103b5.bjj-2020-1393.r2)
  • [L4] There are several procedural options for the treatment of Dupuytren disease. [22] (10.1177/1558944718787281)
  • [L1] There is low level of evidence that both surgical and nonsurgical treatments provide clinically important improvements for recurrent Dupuytren contracture. [23] (10.1177/1558944721994220)
  • [L4] The LF in Dupuytren's disease requires special attention during surgery and rehabilitation. [24] (10.1186/s13018-025-06176-2)
  • [L4] Treatment of Dupuytren disease has shifted from open fasciectomy to collagenase injections, which accounted for 61% of treatments by 2021. [25] (10.1016/j.jhsa.2025.03.013)
  • [L4] Use of a Budapest criteria checklist may guide documentation and speed recognition for an earlier diagnosis of CRPS in patients with Dupuytren's and an atypical post-fasciectomy response. [26] (10.1016/j.jht.2024.09.002)
  • [L2] No significant difference in recurrence rates between needle fasciotomy and collagenase injections three years after treatment of Dupuytren's contracture was found. [27] (10.1016/j.jhsa.2017.06.018)
  • [L4] [29] (10.1177/1753193414560511)
  • [L2] At 3 months and 1 year, the outcomes of needle fasciotomy and collagenase injection are the same in Dupuytren's disease with predominantly metacarpophalangeal joint involvement. [31] (10.1177/1753193415617385)
  • [L2] At 3 months, needle fasciotomy and collagenase injection were not different in correction of finger contracture in Dupuytrens disease, with minor complications. [34] (10.1016/j.jhsa.2014.06.072)
  • [Paper] [35] (10.1016/j.hcl.2018.03.006)
  • [L3] Clinically important Dupuytren's disease is common in the general population, with a majority of diagnosed individuals undergoing treatment. [36] (10.1177/1753193416687914)
  • [L5] The best treatment for Dupuytren contractures continues to be fiercely debated; what is known is that Dupuytren disease is progressive, but the pace is unique to each patient, and best treatments remain uncertain. [38] (10.2106/jbjs.18.00282)
  • [L4] This case demonstrates Dupuytren fibromatosis invading a full-thickness skin graft, suggesting the burden of skin disease may be greater than currently perceived and raising questions about the pathophysiology of recurrence. [40] (10.1016/j.jhsa.2016.04.011)
  • [L1] Collagenase injection and needle fasciotomy have similar 3-year recurrence rates in the treatment of Dupuytren's contracture. [41] (10.1177/1753193418786947)
  • [L4] Proximal interphalangeal joint arthrodesis combined with needle fasciotomy or segmental fasciectomy provides a satisfactory salvage procedure in cases of severe recurrent Dupuytren's disease. [42] (10.1177/1753193420960309)
  • [L4] The findings underline the importance of assessing domains relating to patient satisfaction other than objective hand function measures in Dupuytren's disease. [51] (10.1177/1753193419890284)
  • [L4] The modified McCash technique is a reliable and important technique for managing Dupuytren disease, offering contracture release with minimal dissection, decreased postoperative pain, and reduced risk of contracture and hematoma formation. [52] (10.1016/j.jhsa.2017.01.018)
  • [L4] Dupuytren disease should be included in the differential diagnosis of a nodule in the palm or fingers or contracture of the fingers of children. [54] (10.1016/j.jhsa.2016.08.011)
  • [L4] Dupuytren's disease may remain non-progressive without developing contracture, as demonstrated by two case reports of individuals with palm thickening but no functional impairment over 20 to 30 years. [55] (10.1177/1753193416632644)
  • [L4] This case report explores the anatomic basis and surgical management of radial-sided Dupuytren disease via the unusual presence of a distinct 'lambda' cord of the thumb. [56] (10.1016/j.jhsg.2023.06.013)
  • [L1] [79] (10.1177/1753193420903624)
  • [L1] [81] (10.1016/j.jhsa.2016.06.014)
  • [L4] [84] (10.1258/ht.2010.010008)
  • [L4] [88] (10.1302/2058-5241.4.180021)
  • [L4] [92] (10.1016/j.jhsa.2012.05.022)
  • [L5] [93] (10.1016/j.jht.2024.12.017)
  • [L1] [97] (10.1177/17531934251360545)
  • [L4] [103] (10.1177/1753193415602189)
  • [L4] [104] (10.1007/s11552-014-9645-7)
  • [L4] [105] (10.1016/j.jhsa.2017.11.010)
  • [L1] [110] (10.1177/17531934251315572)
  • [L4] This study suggests that a fasciectomy performed under local anaesthetic with adrenaline and without an arm tourniquet and in a community setting is safe, and results in favourable outcomes regarding the degree of correction of contracture achieved, functional scores, and short-term complications. [115] (10.1302/0301-620x.102b10.bjj-2019-1685.r2)
  • [L4] In patients with Dupuytren disease and severe PIP joint contracture after multiple treatments, this novel procedure consisting of middle-phalanx excision and ligament reconstruction creating a new functioning interphalangeal joint has good short-term outcomes and is a favorable alternative to finger amputation. [124] (10.1186/s12891-019-2701-2)
  • [L3] Dynamism is common in Dupuytren's contractures and may be a source of error or bias in trials using angular deformity as an endpoint. [125] (10.1177/1753193414529074)
  • [L3] The device could potentially be a tool to identify areas of decreased elasticity earlier in the disease. [126] (10.1177/17589983211061616)
  • [L4] The results provide new information about activities that patients with Dupuytren's contracture experience as being difficult to perform and describes positive changes in performance and range of motion. [129] (10.1016/j.jht.2008.08.003)
  • [L3] The intraobserver reliability of sonographic assessment of Dupuytren disease nodules is good, with area measurement being the most reliable. [130] (10.1016/j.jhsa.2020.01.005)
  • [L2] Early postoperative outcomes suggest that microscopic fasciectomy may offer modest short-term advantages in maintaining correction, with lower residual deformity, comparable functional outcomes, and a relatively rapid learning curve. [131] (10.1016/j.jhsg.2026.100955)
  • [L2] In prospectively collected cohorts with a mean 3.8 years of follow-up, recurrence after Dupuytren contracture treatment was common. [134] (10.1016/j.jhsg.2026.100979)
  • [L3] Approximately 10% of patients treated with collagenase injections for Dupuytren contracture underwent surgery within 5 years. [135] (10.1016/j.jhsg.2025.100768)
  • [L5] Many treatment options exist for Dupuytren contracture, each with its own complication profile. [136] (10.1016/j.hcl.2018.03.007)
  • [L4] Fasciectomy has a high initial cost but the lowest reintervention rate. [138] (10.1016/j.jhsa.2019.07.017)
  • [Paper] Mini-open partial fasciotomy for pretendinous Dupuytren contracture represents a safe and effective treatment for MP and PIP joints with only 1 in 5 joints undergoing repeat intervention within 5 years. [139] (10.1177/15589447251339504)
  • [L4] The complication rate was low, but recurrences were frequent in younger patients and for PIP contractures. [140] (10.1016/j.jhsa.2012.01.029)
  • [L4] Percutaneous needle aponeurotomy is an effective technique in the treatment of primary Dupuytren's disease, achieving near-complete correction of contractures with minimal complications. [141] (10.1007/s11552-015-9740-4)
  • [L3] Dupuytren's disease in women presents similarly to men with more severe PIP joint involvement but equivalent surgical outcomes regarding final contracture correction, recurrence, and complication rates. [142] (10.1016/j.jhsa.2007.06.015)
  • [L3] Major complications occurred at roughly half the rate in the staged group, suggesting a potential safety advantage, although the study was underpowered for complication analysis. [143] (10.1016/j.jhsa.2025.10.019)

See Also

  • Dupuytren's Disease
  • Trigger Finger

References

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