Results following surgery for recurrent Dupuytren's disease

This study was designed to assess the subjective and objective results foll owing surgery for recurrent Dupuytren's disease. Nineteen patients (28 fing ers) were treated surgically for recurrent contracture and were located for follow-up analysis at a median of 4 years (range, 1-15 years). Seventeen o f 28 recurrences involved the small finger and 16 patients had at least one component of Dupuytren's diathesis. For the purpose of analysis the patien ts were divided into 3 groups: group A (total active range of motion [TAM] < 150 degrees) consisted of 7 digits treated with limited fasciectomy and i nterphalangeal arthrodesis, group B (TAM greater than or equal to 150 degre es) consisted of 8 digits treated with dermatofasciectomy and full-thicknes s skin graft, and group C (TAM greater than or equal to 150 degrees) consis ted of 13 digits treated with fasciectomy and local flaps. Total active ran ge of motion reflecting the preoperative, immediately postoperative, and fi nal follow-up values revealed that group C (fasciectomy and local flap) was the only group to maintain a statistically significant TAM improvement fro m preoperative (205 degrees) to final follow-up (230 degrees) analysis. Der matofasciectomy and full-thickness skin grafting did not prevent recurrent contracture (preoperative TAM = 175 degrees; final follow-up TAM = 150 degr ees). 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 satisfie d with their experience and would undergo the procedure again. (J Hand Surg 2000; 25A:291-296. Copyright (C) 2000 by the American Society for Surgery of the Hand.).