Percutaneous fasciotomy for the treatment of Dupuytren's disease-a systematic review.

Abstract

Dupuytren's disease is described as a thickening of the palmar fascia. It typically affects men of Northern European descent in their fifties. The disease process starts as a nodule at the distal palmar crease that progressively gives rise to a cord invading distally toward the finger. Historically, different treatments have been described. Our purpose was to perform a meta-analysis of the evidence published on the percutaneous fasciotomy (PCF) treatment. We searched Medline, PubMed, and the Cochrane Library for articles evalu ating the use of PCF for Dupuytren's disease. No study was excluded based on quality. The search yielded nine studies. Because of their different methodologies, a meta-analysis could not be performed. However, we were able to extract common qualitative conclusions. PCF is an effective treatment modality for patients in whom general anesthesia is contraindicated, with a good outcome especially at the metacarpophalangeal joint, a low recurrence rate in the short term, and few complications. Similar conclusions were reached by all the articles under study. Nevertheless, there remains the need for a prospective study with a higher statistical power and standardized clinical evaluation and surgical methods in order to achieve more objective quantitative results. It would also be pertinent to compare the outcomes and complication rates of PCF with the new collagenase treatment.