Dupuytren's contracture. How limited should a limited fasciectomy be?

Abstract

The author submits a material of 520 operated cases of Dupuytren's contracture from the Department of Hand Surgery, Orthopaedic Hospital, Copenhagen, followed for 2-8 years. On the basis of the 183 oldest cases, 70 having total and 113 limited fasciectomy, it is concluded that the future operative method should be limited fasciectomy. 450 cases treated by limited fasciectomy were included in the follow-up study. These cases were analysed according to which surgeon had performed the operation. The technique had differed somewhat, and from the material it is apparent that the operation ought to be a balance between local radicality and gentle treatment of the tissues to avoid local recurrence on the one hand and cicatricial contractions and posttraumatic fibrosis and dystrophy on the other. In the most severe cases plastic repair of the skin or a McCash procedure should be applied.