This study reviews one hundred patients with Dupuytren's disease treated surgically by the Derby Hand Unit between January 1975 and September 1981. One hundred and twenty-eight operations were assessed with a follow-up period from nine months to ninety months, average thirty-eight months. In thirty-five patients the overlying skin was excised and replaced by a full-thickness skin graft (dermofasciectomy). The remaining patients were treated by fasciectomy without skin excision. The overall recurrence rate after surgery was found to be 46.5%. However, skin excision andreplacement following fasciectomy prevented any appreciable, if not all recurrence of Dupuytren's tissue. The function of the hand was assessed with regard to the improvement in flexion contracture; ability to flex the finger to the distal palmar crease; sensibility of the replaced skin; time to return to work and full activity. It was concluded that skin replacement did not jeopardise hand function. © 1984 The British Society for Surgery of the Hand, The Royal College of Surgeons, Lincoln's Inn Fields, London WC2A 3PM.
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