Needle fasciotomy vs limited fasciectomy (5-year)

Five-year results of a randomized clinical trial on treatment in Dupuytren's disease: percutaneous needle fasciotomy versus limited fasciectomy

van Rijssen AL, Ter Linden H, Werker PMN Plastic and reconstructive surgery 2012 · PMID 21987045 · doi:10.1097/prs.0b013e31823aea95

Question

In Dupuytren's contracture, how does percutaneous needle fasciotomy compare with limited fasciectomy in the long term?

Design

Single-centre Dutch RCT with five-year follow-up.

Patients

Patients with Dupuytren's contracture of at least 30 degrees total passive extension deficit.

Intervention

Percutaneous needle fasciotomy (PNF)

Comparison

Limited fasciectomy

Primary outcome

Recurrence of contracture at 5 years

Key result

Recurrence was significantly and substantially more frequent and earlier after needle fasciotomy than after limited fasciectomy, although PNF had faster recovery and fewer complications.

Limitations

Single centre; surgeon-dependent techniques; recurrence definitions vary across Dupuytren studies, making comparison difficult.

Impact on practice

Supports offering PNF as a quick, low-morbidity option (especially for older patients or MCP-predominant disease) while counselling that fasciectomy gives more durable correction.