There are only three Level I studies comparing surgical techniques for the treatment of primary Dupuytren ’s contracture , and the evidence does not support one procedure above another , other than to show a particularly high recurrence rate after needle fasciotomy .
There is no consensus on the most effective operation for primary Dupuytren ’s contracture .
This systematic review evaluates the reported rates of recurrence and complications , as well as the strength of evidence , for individual procedures .
Skin Tension in the Aetiology of Dupuytren’s Disease; a Prospective Trial
Tension in the palmar fascia has been proposed as a factor causing Dupuytren ’s disease . If tension does stimulate the growth of new Dupuytren ’s tissue , relieving longitudinal tension should reduce the recurrence rate following surgery . Thirty patients with palmar Dupuytren ’s contracture of a single ray that affected only the metacarpophalangeal joint were divided into two groups . Both groups had a fasciotomy : one group through a transverse incision that was closed directly and the other through a longitudinal incision with Z-plasty closure . Half the patients ( seven of 14 ) who had direct closure had recurrence at 2 years as compared to two of the 13 in the Z-plasty group . The trial was stopped at the interim analysis stage due to the high recurrence rate in the first group . These results are consistent with the tension hypothesis for the aetiology of Dupuytren ’s disease
There are only three Level I studies comparing surgical techniques for the treatment of primary Dupuytren ’s contracture , and the evidence does not support one procedure above another , other than to show a particularly high recurrence rate after needle fasciotomy .
There is no consensus on the most effective operation for primary Dupuytren ’s contracture .
This systematic review evaluates the reported rates of recurrence and complications , as well as the strength of evidence , for individual procedures .