Multiple Recurrences in Aggressive Forms of Dupuytren’s Disease—Can Patients Benefit from Repeated Selective Fasciectomy?

• Published in: Plastic and reconstructive surgery. Global open Vol. 5; no. 2; p. e1247
• Main Authors: Könneker, Sören, Broelsch, G Felix, Krezdorn, Nicco, Dastagir, Khaled, Kuhbier, Jörn W, Paprottka, Felix J, Vogt, Peter M
• Format: Journal Article
• Language: English
• Published: United States Copyright The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved 01.02.2017; Wolters Kluwer Health
• Subjects: Original
• ISSN: 2169-7574; 2169-7574
• DOI: 10.1097/GOX.0000000000001247

BACKGROUND:In Dupuytren’s disease (DD), limited fasciectomy is the mainstay of surgical therapy in patients at risk of contractures and disease recurrences. New minimally invasive treatments such as injection of collagenase clostridium histolyticum have evolved as a common tool for the preliminary treatment of Dupuytren’s contractures. However, recurrences and their therapy remain controversial. In this study, we evaluate the benefit of repeated limited fasciectomy in patients with aggressive forms of the disease and multiple recurrences of contractures. METHODS:We evaluated the outcome of 16 patients undergoing limited fasciectomy 3 or more times on a single hand. RESULTS:Postoperatively, 10 of 13 (76.9%) patients were satisfied with the clinical result after the last operation; 10 of 12 (83.3%) patients would choose to have their surgery repeated, if so needed. The mean improvement of proximal interphalangeal joint range of motion was 59.2 degrees (SD 26.8) and 86.2% (SD 19.9). There were no severe complications after treatment within the observed time period. CONCLUSIONS:Our findings demonstrate that patients with recurrence of contractures after multiple previous treatments in aggressive forms of DD can benefit from surgical intervention. In conclusion, repeated limited fasciectomy remains indicated in patients after previous surgeries with DD.