gms | German Medical Science

Objectives/Interrogation: The advantage of needle fasciotomy is a very short recovery combined with high cost effectiveness compared to open surgery. The purpose of this study is to report results, reduction of contracture, complications and early recurrence after four years.

Methods: The indication was contractures of the MCP joint in stages I, II, III and IV with well defined fibrosis. The contracted Dupuytren's tissue is divided longitudinally along multiple points so that the finger can stretch out straight again. The procedure is performed with a needle through the skin and the sharp, small bevel of the needle is used to cut the Dupuytren's tissue beneath the skin. We also administer a corticosteroid injection to the treatment area at the time of the procedure. Stretching, exercises and extension splinting during the recovery phase are important to gain maximum benefit from the procedure. The patients were evaluated preoperatively and per-operatively at one, eight, twenty-four weeks, after one, two, three, four years. 117 patients with 129 fingers were operated. Median age was 59 (44-74) with 114 man and 3 women.

Results and Conclusions: No cases of flexor tendons lesions, hematomas or infections were registered.

The patients were allowed to use the hand directly after the procedure.

Needle aponeurotomy does not involve incisions to the skin of the hand, so there is less tissue damage, less swelling, less pain, less down time and quicker healing Needle fasciotomy is a good alternative in cases with well defined fibrosis because of these preliminary good results and low morbidity.