The Re-Emergence of Percutaneous Fasciotomy in the Management of Dupuytren’s Disease

Dupuytren’s disease is a common condition. Its management has gradually evolved but still remains a source of much controversy. Recently there has been a resurgence in the popularity of percutaneous needle fasciotomy. It is a simple method that uses a hypodermic needle as a scalpel blade. It is usually performed in the out-patient setting under local anaesthesia without a tourniquet. It has few complications and allows almost immediate return to work with few restrictions. It can provide complete deformity correction and may offer a long-term solution in selected patients. It is also useful in converting advanced contractures into milder deformities, allowing a second stage digito-palmar fasciectomy to be more successful. Recurrence is earlier than with more formal and invasive techniques but the procedure can be repeated and does not preclude the patient from further surgery. This article reviews the technique and assesses the efficacy and outcomes of published data.