title: Minimally invasive partial fasciectomy for Dupuytren's contractures.
abstract: BACKGROUND
  Numerous options exist for the treatment of Dupuytren's contracture. This study describes the technique and early results of partial fasciectomy through a mini-incision approach as an additional treatment option for Dupuytren's disease.
  
  
  METHODS
  This procedure involves the excision of diseased Dupuytren's tissue with the use of multiple 1 cm transverse incisions. Patient demographics, digit involvement, the number of incisions required to release each digit, and complications were recorded for all patients. Range of motion data was obtained from a subgroup of patients that had at least 6 months of follow-up. A paired t test was used to compare preoperative and postoperative contracture.
  
  
  RESULTS
  Sixty-seven patients underwent 75 procedures that involved 119 digits. The mean patient age at the time of surgery was 63 years (range, 33-95 years). A total of 32 digits (47 joints) were available for range of motion analysis. After a mean of 2.2 years following surgery, metacarpophalangeal joint contractures maintained correction (34° preoperatively, 19° postoperatively, p = 0.008). After a mean postoperative duration of 2.0 years, proximal interphalangeal joint contractures trended worse than preoperative levels (39° preoperatively, 45° postoperatively, p = 0.319). There was one major complication, which consisted of a nerve laceration that was identified and repaired intraoperatively.
  
  
  CONCLUSIONS
  Partial fasciectomy through the described mini-incision approach provides an additional surgical option for patients who desire a less invasive surgical procedure than traditional fascietomy. Although this procedure is safe and effective at achieving immediate cord release, maintenance of correction for proximal interphalangeal joint contractures remains problematic.
authors.affiliation: Division of Hand Surgery, Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, 834 Chestnut Street, Suite G114, Philadelphia, PA 19107 USA ; The Commonwealth Medical College, 525 Pine St, Scranton, PA 18509 USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Gelman
authors.forename: Robert
authors.initials: R
authors.lastname: Schlenker
authors.forename: Abdo
authors.initials: A
authors.lastname: Bachoura
authors.forename: Sidney M
authors.initials: SM
authors.lastname: Jacoby
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lipman
authors.forename: Eon K
authors.initials: EK
authors.lastname: Shin
authors.forename: Randall W
authors.initials: RW
authors.lastname: Culp
keywords: Dupuytren’s contracture; Fasciectomy; Minimally invasive