Needle aponeurotomy in the management of Dupuytren’s contracture

Abstract

Dupuytren’s contracture (DC) is a benign fibroproliferative disorder of the fascia of the hand and fingers. Progressive thickening and shortening of the palmar fascia results in the formation of cords and ultimately flexion deformities of the digits, with associated functional loss. Surgical intervention aims to correct contracture and improve the hand function by either division of (fasciotomy) or removal of (fasciectomy) the diseased tissue. Current treatment options for DC include open fasciectomy (OF), limited fasciectomy (LF), needle aponeurotomy (NA), and collagenase injections. Needle aponeurotomy (NA) is a minimally invasive technique that uses a small hypodermic needle as a percutaneous scalpel blade to perforate, weaken, and/or divide the affected cords. This chapter focuses on the use of NA, its indications, advantages, disadvantages, technical pearls, and literature review. Pertinent comparisons between NA and other treatment options are also discussed.