The Dupuytren Contracture Controversy

Abstract

Radical fasciectomy has been regarded as the only suitable treatment for the Dupuytren contracture. Recent interest in limited fasciectomy and subcutaneous fasciotomy has given rise to a controversy in the treatment of this disease. The proponents of radical fasciectomy feel that it is the only means of curing an established contracture. Those who oppose this procedure point to the higher postoperative morbidity of the radical procedure and the longer duration of disability from operation to employment. Limited fasciectomy and subcutaneous fasciotomy possess the handicap of a higher recurrence rate; the latter procedure bears with it a risk of accidental division of tendons, vessels, and nerves. Since there is disagreement as to the relative merits of radical versus the limited procedure, it is important to determine the most suitable indications for each.