Percutaneous aponeurotomy: a useful or dangerous technique? 106 cases reviewed with 5 and 10 years follow-up

From a set of 106 hands with Dupuytren’s disease, operated on by 3 senior surgeons in the operating room under regional anesthesia, an independent examiner assessed 71 hands clinically and 20 others by telephonic survey in order to appreciate effectiveness and dangerousness of percutaneous aponeurotomies.At 5 years follow-up, 80% patients are satisfied even tough 100% have a recurrence according to Leclercq and Tubiania’s criteria. Few complications and an average 45% improvement of extension for the involved digits explain this paradox. Results are much better at the MP level with 61% improvement compared to only 19% at the PIP level. Difference is even more important about complete extension which is maintained for 47% of the MP joints compared to only 2% of the PIP joints.In spite of the course of the disease, re-operative rate is only 22% at 5 years and 37% at 10 years.This technique is reliable with few complications; its objective results are moderate but patient’s satisfaction is high. It should be offered to selected and informed patients who accept its only limit, recurrence of the disease.