Dupuytren's disease – treatment particularities

Abstract

Introduction. Dupuytren’s contracture affects the palmar and digital fascia, leading to irreversible hand deformity. This disease increasingly plays a major role in the pathologies that plastic surgeons are concerned with. So, being a slowly progressive contracture, the treatment tactic remains decisive.Purpose. Highlighting the peculiarities of surgical treatment in Dupuytren's disease and dilemmas faced by the surgeon, depending on the stage of the disease, to obtain a good function of the upper limb, avoiding complications and recurrences. Material and methods. In the Clinic of Plastic, Aesthetic Surgery and Reconstructive Microsurgery, in 2010-2021, were performed surgery on 50 patients with Dupuytren's disease – percutaneous needle fasciotomy, subtotal fasciectomy, subtotal fasciectomy with autodermoplasty.Results. Percutaneous fasciotomy is the minimally invasive method, which is applied to resolve cases that require rapid recovery, without extensive intervention. It can be performed in the initial stages of the disease (Stages I-II Tubiana).Or can be used as the first stage of surgery, in case of advanced contractures (Stages III-IV Tubiana), which can result in skin defects.Subtotal fasciectomy still remains the most common method of surgical treatment, which can be staged with autodermoplasty (in case of skin defects), with good functional results and a low number of recurrences.Conclusions. The more advanced is the stage of Dupuytren's disease and the longer is the duration of the disease, the weaker is the response to surgical treatment of the contracture and the greater is the risk of irreversible joint contracture, regardless of the choice of surgical treatment method.