Efficacy of percutaneous needle fasciotomy in Dupuytren's disease: a systematic review

Abstract

Purpose Dupuytren's disease is a chronic and irreversible fibroproliferative condition that affects the palmar fascia of the hand, decreasing quality of life. The aim of this review is to, though existing literature, assess efficacy, patient satisfaction and complications of percutaneous needle fasciotomy (PNF) in this disease. Methods After performing a judicious search and review process, 11 articles were included. All of them met our primary and secondary outcomes, such as the efficacy of this treatment in Dupuytren disease, percentage of full release, recurrence, mean QuickDASH score variation, and patient satisfaction. We extracted results that were considered important in a Microsoft Excel® spreadsheet. We determined the number of treated articulations, median follow-up time, preoperative and final TPED, and preoperative and final mean QuickDASH scores, percentage of correction, and recurrence rate. A total of 2003 percutaneous fasciotomy procedures were evaluated. Results We calculated the percentage of correction by considering the variation of the Total Passive Extension Deficit (TPED) before and after this procedure, ranging from 55,8 to 92%. The highest value obtained for recurrence rate was 48%. Complications such as skin lacerations, hypoesthesia, bruising, swelling, or tendon rupture were described. The QuickDASH questionnaire was evaluated in the post-fasciotomy period and revealed an increase in patient satisfaction after fasciotomy. Conclusions Percutaneous needle fasciotomy can provide satisfactory results in the treatment of Dupuytren disease. It has a good percentage of correction, associated with low complication and recurrence rates. In addition, the patient satisfaction was good.