Modified percutaneous needle aponeurotomy for the treatment of dupuytren's contracture: early results and complications.
BACKGROUND
The purpose of our study was to identify postoperative results and complications using a percutaneous approach to treat Dupuytren's contracture in a consecutive series of patients.


METHODS
A review of all patients with Dupuytren's contracture treated with percutaneous needle aponeurotomy (NA) from 2008 to 2010 was performed. Patient demographics, digits affected, and disease severity was recorded. Pre-operative total passive extension deficit (TPED) was calculated for each affected digit. TPED in the immediate postoperative period and at the time of most recent follow-up was measured. Treatment-related complications and incidence of disease recurrence were identified. Statistical analysis was performed using paired t-test. (Statistical significance p-value <0.05).


RESULTS
525 digits in 193 hands were treated with NA. 140 patients were male, average age was 65 years. The average preoperative TPED was 41° and the average immediate postoperative TPED was 1° (98% correction) (P=0.0001). The average TPED at 4.5 month follow up was 11 o (73% correction). Complications included infection in 3 patients and one case each of triggering, delayed flexor tendon rupture, complex regional pain syndrome and persistent numbness. Recurrence was observed in 62 digits.


CONCLUSIONS
Percutaneous needle aponeurotomy is an effective technique in the treatment of Dupuytren's contracture. Near complete correction of contracture was achieved and few complications were observed. Longer follow-up is needed to determine if these short-term results are maintained.
Division of Plastic and Reconstructive Surgery, University of California Los Angeles, Los Angeles, CA 90095 USA ; Department of Orthopaedic Surgery, University of California Los Angeles, Santa Monica, CA 90404 USA ; Division of Plastic and Reconstructive Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, South Carolina 29425 USA.
Fernando A
FA
Herrera
Department of Orthopaedic Surgery, University of California Los Angeles, Santa Monica, CA 90404 USA.
Scott
S
Mitchell
Department of Orthopaedic Surgery, University of California Los Angeles, Santa Monica, CA 90404 USA.
Mark
M
Elzik
Division of Plastic and Reconstructive Surgery, University of California Los Angeles, Los Angeles, CA 90095 USA.
Jason
J
Roostaeian
Division of Plastic and Reconstructive Surgery, University of California Los Angeles, Los Angeles, CA 90095 USA ; Department of Orthopaedic Surgery, University of California Los Angeles, Santa Monica, CA 90404 USA.
Prosper
P
Benhaim
Complications; Dupuytrens contracture; Needle aponeurotomy