Transcutaneous Fibrosis Perforation (Needle Fasciotomy) in Dupuytren’s Disease—A Retrospective Analysis of 1803 Cases

Background: Percutaneous needle fasciotomy has been practiced for many years as a therapeutic alternative to open fasciectomy in Dupuytren's disease. In addition to collagenase injection, it had established itself as a minimally invasive procedure in everyday clinical practice. This study analyzes the treatment results of 1146 patients. Methods: Patients at a center for needle fasciotomy were surveyed retrospectively by means of a questionnaire. In addition to previous illnesses and the localization and number of affected fingers, the frequency of recurrences, the need for renewed treatment and satisfaction with the surgical result were also surveyed. Results: Between 1994 and 2012, 1146 patients with 1803 finger rays were treated and their data analyzed on the basis of records. In addition, a questionnaire survey on patient satisfaction was conducted and 174 questionnaires were analyzed. 83% of the patients were male, 16% female. In 50% of cases the right side was treated, in 45% of cases the left side (5% unknown). 46% of the finger rays treated were on the little finger and ring finger. In all but one case, an improvement in the contracture was achieved. Complications included skin tears (264 cases), increased swelling (5 cases), hypesthesia (1 case), flexor tendon rupture (4 cases) and a mid-limb base fracture (1 case). The mean operation time was 26.9 minutes, the duration of pain was 2.7 days, and patient satisfaction on a scale of 1-10 was 7.2. 77% of patients stated that there had been a further deterioration or recurrence within one year of treatment, and 35% of these patients stated that further treatment was necessary. Conclusion: Needle fasciotomy is a safe and effective method with a low complication rate, but targeted and stringent follow-up treatment is necessary, as is information about possible recurrences or further deterioration of the result.