Dupuytren's Percutaneous Needle Fasciotomy

Percutaneous needle fasciotomy is an outpatient procedure when one or more fibrous bands in either the palm or the fingers are cut using a blade or the bevel of a needle.

The disease often runs in families and presents as benign scar tissue developing spontaneously under the skin of the palm or fingers (and occasionally the feet). The little finger side of the hand is most often affected. Removal by surgery does not stop further tissue appearing and further development is unpredictable.

Although painless, the thickening and tightening of the scar tissue tends to pucker the skin and causes contractures of the fingers. The tendons and nerves are not affected so grip and function remain virtually normal unless there is a severe contracture. Some people develop small tender nodules under the skin on the back of the finger joints. The condition can also occur in the feet.

PNF is suitable to give a certain level of relief if the tissue feels like a cord and is causing a contracture. This technique has the lowest complication rate, and very rapid recovery, but does not get rid of the nodules or thickened tissue.

Surgery (fasciectomy or dermofasciectomy) is the only way of fully removing the tissue.

The procedure

The consultant performs the procedure under local anaesthetic, piercing the cord like tissue multiple times with a needle until it gives way.

Recovery

Occasionally there is a tear in the skin which should be dressed until it heals but you should be able to use your hand normally immediately. You will not need to take any time off work.

There is a recurrence rate of approximately 50% after two years.