A review of common practice in Dupuytren surgery

Aspects of decision making, postoperative management, and complications routinely discussed with patients were investigated using a questionnaire completed by 141 hand surgeons of various grades who regularly manage Dupuytren disease. This account presents the results of this questionnaire study, and the literature is discussed in context. A brief description of operative technique in fasciectomy and dermofasciectomy is included. Thresholds for surgery did not differ greatly among the surgeons who completed the questionnaire. The training background and the number of operations performed by surgeons also did not generally influence surgical decision making. Postoperative care regimens were very similar. However, there was great variation in the complications routinely included in discussions with patients undergoing surgery for Dupuytren contracture. Recurrence and nerve damage were the only 2 mentioned by almost all surgeons. There was also diversity in what rates were quoted for complications, particularly recurrence (median 33%, range 0%-100%) and stiffness (median 10%, range 0%-100%).