Effectiveness of Percutaneous Needle Fasciotomy for Second or Higher Recurrence in Dupuytren Contracture

Fig. 23.1

59-year-old male, who had his first PNF at the age of 54 for right middle, ring and small MCP contractures (a, b, before the first PNF; c, d, 1 year after the first PNF). Two years after the first PNF, he developed a recurrence in his right hand (e, f), which was treated again with PNF because of a 50° small MCP contracture and a 35° ring MCP contracture. The contractures were corrected completely (g, h). Three years after his second PNF, his right hand was treated again for a 30° small MCP contracture and a 60° small PIP contracture (i, j). These contractures were corrected to 0° and 20°, respectively (k, l)

Fig. 23.2

Overview of rays treated by PNF in between 2007 and 2014

Fig. 23.3

Overview of reduction of TPED

Shown are the numbers of rays treated for primary DD or recurrences. The number of rays that were treated with PNF are shown, as well as the numbers of rays that were treated with LF. The patients who chose LF at any moment were not further included in the study. There was one ray included that had PNF for the first contracture, LF for the first recurrence and PNF for the second recurrence.

A third and fourth treatment with PNF were equally as effective as a primary or second treatment (p = 0.738).

23.4 Discussion

The aim of this study was to find out if PNF is an effective treatment option for second or higher recurrences of DD. This study showed that the effectiveness of PNF for second and third recurrences was high. Even with a fourth treatment with PNF, we found similar results as with primary PNF results described in literature (van Rijssen et al. 2012; van Rijssen and Werker 2012). Unfortunately, a fifth treatment was not as effective as earlier treatments, although the number of cases is small.

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