Percutaneous Needle Aponeurotomy: A Viable Option for Management of Dupuytren’s Contracture

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Author(s): 1.Samia Fatima,2 Roomana Akhlaque,3 YawarSajjad,4 Nabila Naz

Received: 05/05/2020 | Published: 20/11/2020 | Pages: 47-50 |

Dupuytren’s contracture (DC) is a progressive disease characterized by thickening of connective tissue of the palmar fascia and formation of cords which progressively thicken and shorten resulting in flexion contractures of joints. Over the last few decades, there is paradigm shift towards minimally invasive procedures for this problem. Percutaneous needle aponeurotomy has the benefits of being minimally invasive, providing rapid healing and recovery time, and early return to work. Furthermore, there is reduced need for formal occupational therapy. Methods: This is a prospective cohort study of all patients who were managed with Percutaneous Needle Aponeurotomy(PNA) for Dupuytren’s contracture at the plastic and reconstructive surgery department of Lahore General Hospital from September 2017-August 2019.PNA was performed in the operating room, under local anesthesia without using sedation. Result A total of 17.hands were treated with percutaneous aponeurotomy .The degree of total residual extension deficit was the primary outcome of the procedure. Average follow-up period was 10 months. After the follow-up period, recurrence was detected in 5 patients (29.4%). There was an improvement from baseline of 80 percent(40-45 degrees) at the 10-months follow-up. Conclusion: PNA technique provides significant advantages in the choice of surgical treatment options for DC as it is less invasive than other methods, feasible under local anesthesia, has low complication rates with shorter hospital stay, allows rapid return to work, and has low cost. Keywords | Dupuytren’s contracture, Percutaneous Needle Aponeurotomy