A NEW MEDICAL TREATMENT FOR DUPUYTREN'S DISEASE.

 

Regarded as a surgical disease since its first description in 1831, the Dupuytren's contracture can nowadays be treated non-surgically using needle aponeurotomy.

It is an outpatient procedure, ensuring prompt improvement and much more inexpensive than surgery.

Needle fasciotomy has been proposed in 1970s by the rheumatologists of Lariboisiere Hospital (France - Paris).

Lermusiaux published the first short-term and three years results in 1979. Progressively, this medical technique became a well-established first-line treatment of Stage I to III of Dupuytren's disease for both palmar and digital forms.

In 1987, Badois suggested the term "Needle Aponeurotomy" or "Needle Fasciotomy" in an article discussing indications of this technique.


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This non-surgical procedure has been criticized for the last ten years by hand surgeons, but the publications of articles reporting important series in 1993 (123 hands) and 1996 (992 hands) showed that needle aponeurotomy is an oustandingly effective and simple procedure which does not involve risk and which causes very minimal inconvenience.

Five years results show that recurrence rate is quite comparable with surgical one, although they seem slightly earlier.

Nevertheless, it is easier to repeat fasciotomy than accept the prospect of a more complicated operation.


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