Mini-Open Partial Fasciotomy for Dupuytren Contracture: Time to Reintervention

Background In younger patients with Dupuytren contracture, recurrence is common over time. Mini-open fasciotomy is a surgical approach that maintains virgin tissue at the palmar digital crease. This study's primary aim is to determine time to repeat intervention after mini-open partial fasciotomy for Dupuytren contracture and to report the rate of postoperative complications.MethodsRetrospectively, all patients who underwent minimally invasive open partial fasciotomy for Dupuytren contracture with a pretendinous cord under the care of a single surgeon from 2015 to 2022 were identified. Degree of contracture of the metacarpophalangeal (MP) and proximal interphalangeal (PIP) joints were recorded preoperatively and at each subsequent office visit. Postoperative complications, recurrence of flexion contracture (>20°), and reoperation were recorded.ResultsTwenty-eight patients undergoing procedures on 39 digits with 44 joint contractures were included, consisting of 34 fingers with MP contractures and 5 fingers with both MP and PIP contractures. The median follow-up was 5.0 (interquartile range [IQR] = 3.6-6.9) years. The median preoperative MP contracture was 47.5° (IQR = 35°-62°), which corrected with a median contracture of 15.0° at the final measurement, 2.4 years postoperatively. The median preoperative PIP contracture was 52.5° (IQR = 39°-71°), which corrected with a median 15.0° at the final measurement, 1.5 years postoperatively. Contracture recurrence occurred in 16 (36%) joints (36%) at 3.7 (IQR = 2.7-4.4) years. Younger age (odds ratio [OR] = 0.87, P = .003) and male sex (OR 21.9, P = .014) were independently associated with contracture recurrence. Nine MP joints (20%) underwent reoperation at a median 4.1 (IQR = 3.3-6.0) years.ConclusionsMini-open partial fasciotomy for pretendinous Dupuytren contracture represents a safe and effective treatment for MP and PIP joints with only 1 in 5 joints undergoing repeat intervention within 5 years.