Dupuytren's disease

Abstract

Dupuytren's contracture is a common disorder in which proliferation of the palmar fascia leads to contractures of the fingers causing significant loss of hand function. In the early stages Dupuytren's presents with palmar nodules, which are best managed non-operatively, usually with observation. There is little evidence that any non-surgical intervention improves the long-term outcome. If the disease progresses to form cords with contractures that restrict hand function, surgical intervention is indicated. The surgical options range from percutaneous needle fasciotomy, through regional fasciectomy to dermofasciectomy and skin graft. The bigger procedures have a better chance of achieving a full correction of the deformity and a lower risk of recurrence, but the morbidity is greater and the recovery period longer. The choice of treatment is a balance between risks and benefits and should be a shared decision between the patient and surgeon.