Fasciectomy and conservative full thickness skin grafting in Dupuytren's contracture. The fish technique

Abstract

We reviewed 79 patients with a total of 100 digits affected by Dupuytren's disease, who were treated surgically in our institution between 1990 and 1998. The mean follow-up was 4.4 years with a range of 2 to 10 years. Only patients with PIP joint deformity of more than 30 degrees were included in the study. All patients had radical excision of diseased fascia tissue to the mid axial line and application of a full thickness skin graft over the proximal phalanx without any skin excision. Twenty two rays had two-stage operations involving percutaneous fasciotomy and application of S-Quattro followed by the definitive procedure after an interval of 6-8 weeks. Patients were clinically assessed for recurrence, extension of disease, 2-point discrimination, finger sensation, graft or donor site problem and patient satisfaction. Seven fingers had recurrent disease, none of which crossed the graft. The present study shows that radical excision of Dupuytren's tissue with full thickness graft without excision of involved skin as a primary procedure reduces recurrence. These results are comparable to those for dermofasciectomy, as reported in previous series.