Needle fasciotomy for Dupuytren's contracture- a prospective cohort study of 58 fingers with a median follow-up of 6.5 years

Needle fasciotomy (NF) is a minimally invasive treatment option for Dupuytren contractures, but long-term results have indicated a high recurrence rate. This prospective study was initiated to monitor the introduction of NF in a context where limited fasciectomy had been the only treatment option, and to investigate the long-term results. The inclusion criterion was a palpable cord with a Metacarpophalangeal (MCP) and/or Proximal interphalangeal (PIP) contracture in one or more fingers. Fifty-eight fingers in 42 patients (40 male and 2 female with a median age of 68 years) were treated by needle fasciotomy between November 2010 and March 2012, and were followed for a median of 6.5 years. The median total passive extension deficit (TPED) was 52 degrees at baseline, but decreased significantly to 20 degrees postoperatively. No severe adverse events such as nerve or tendon injuries were reported. At final-follow up of 48 fingers the median TPED was still significantly reduced to 23 degrees for all fingers (p < 0.0001). Twenty-nine fingers retained full correction of the contracture, and in patients with recurrent contractures NF was preferred in 13 out of 17 patients. This study showed that needle fasciotomy is a safe procedure for Dupuytren's contracture, with excellent immediate reduction of the joint contracture and with a recurrence rate comparable to treatment by collagenase clostridium histolyticum (CCH).