title: Cost comparison of open fasciectomy versus percutaneous needle aponeurotomy for treatment of Dupuytren contracture.
abstract: BACKGROUND
  Many surgical options exist for the treatment of Dupuytren contracture. Little has been written regarding their financial implications. The purpose of this study was to compare the immediate direct costs of open fasciectomy to percutaneous needle aponeurotomy (NA) for the surgical treatment of Dupuytren contracture.
  
  
  METHODS
  A retrospective review was performed comparing patients treated with open fasciectomy (group 1) to patients treated with percutaneous NA (group 2) for the treatment of Dupuytren disease from 2008 to 2010. Financial and medical records were reviewed. Direct cost of treatment was calculated from hospital billing records, including surgical, anesthesia, and facility fees. Statistical analysis was performed using unpaired t test.
  
  
  RESULTS
  Twenty-four patients received open segmental palmar and/or digital fasciectomy (group 1). Average preoperative metacarpophalangeal joint flexion contracture was 30 degrees, and proximal interphalangeal joint flexion contracture was 42 degrees. Group 2 consisted of 24 patients. Average preoperative metacarpophalangeal flexion contracture was 31 degrees, and proximal interphalangeal flexion contracture was 27 degrees. Mean cost for group 1 was $11,240 and mean cost for group 2 was $4657 (P < 0.0001). Immediate postoperative contracture correction was similar between both. Two complications occurred in group 1 (wound dehiscence and nerve injury); no complications in group 2.
  
  
  CONCLUSIONS
  Percutaneous NA is associated with decreased direct costs in the short-term compared to traditional open fasciectomy with comparable deformity correction.
authors.affiliation: From the *Division of Plastic and Reconstructive Surgery and †Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA.
authors.forename: Fernando Antonio
authors.initials: FA
authors.lastname: Herrera
authors.forename: Prosper
authors.initials: P
authors.lastname: Benhaim
authors.forename: Ahmed
authors.initials: A
authors.lastname: Suliman
authors.forename: Jason
authors.initials: J
authors.lastname: Roostaeian
authors.forename: Kodi
authors.initials: K
authors.lastname: Azari
authors.forename: Scott
authors.initials: S
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D004387:Dupuytren Contracture / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D019637:Orthopedic Procedures / Q000191:economics / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies