From the Research
Specialized hand surgeons, orthopedic surgeons, or plastic surgeons with specific training in minimally invasive procedures, as well as rheumatologists in some healthcare settings, can perform a needle fasciotomy for Dupuytren's contracture. These specialists should have experience in hand surgery and a thorough understanding of the complex anatomy of the hand, particularly the fascia and surrounding neurovascular structures. The procedure involves using a needle to puncture and divide the contracted cord of tissue under local anesthesia, allowing for immediate finger extension. While less invasive than open surgery, it requires precise technique to avoid damage to nearby nerves, blood vessels, and tendons.
Key Considerations
- Practitioners need to be skilled in identifying appropriate candidates for the procedure, as not all Dupuytren's contractures are suitable for needle fasciotomy 1.
- Patients with more advanced disease or recurrent contractures may require more extensive surgical interventions.
- The provider should also be able to manage potential complications such as tendon rupture, nerve injury, or bleeding, though these are relatively rare when performed by experienced clinicians 2.
Procedure Details
- The procedure can be performed in an outpatient clinic setting with minimal resources 3.
- Multiple contractures can be treated during the same session, and the treatment is considerably easier for the patient and requires a minimum of rehabilitation compared with limited fasciectomy 3.
- The immediate treatment effect in terms of reduction of the contracture is readily assessed, and the procedure can be performed at additional levels if needed 3.