Original Communications| Volume 25, ISSUE 2, P291-296, March 2000

Results following surgery for recurrent Dupuytren's disease


      This study was designed to assess the subjective and objective results following surgery for recurrent Dupuytren's disease. Nineteen patients (28 fingers) were treated surgically for recurrent contracture and were located for follow-up analysis at a median of 4 years (range, 1–15 years). Seventeen of 28 recurrences involved the small finger and 16 patients had at least one component of Dupuytren's diathesis. For the purpose of analysis the patients were divided into 3 groups: group A (total active range of motion [TAM] < 150°) consisted of 7 digits treated with limited fasciectomy and interphalangeal arthrodesis, group B (TAM ≥ 150°) consisted of 8 digits treated with dermatofasciectomy and full-thickness skin graft, and group C (TAM ≥ 150°) consisted of 13 digits treated with fasciectomy and local flaps. Total active range of motion reflecting the preoperative, immediately postoperative, and final follow-up values revealed that group C (fasciectomy and local flap) was the only group to maintain a statistically significant TAM improvement from preoperative (205°) to final follow-up (230°) analysis. Dermatofasciectomy and full-thickness skin grafting did not prevent recurrent contracture (preoperative TAM = 175°; final follow-up TAM = 150°). Thirteen patients had abnormal Semmes-Weinstein monofilament testing and 8 had abnormal 2-point discrimination. There were 3 anesthetic digits. Despite these findings, 18 of the 19 patients were unconditionally satisfied with their experience and would undergo the procedure again. (J Hand Surg 2000; 25A:291–296, Copyright © 2000 by the American Society for Surgery of the Hand.)


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