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General Orthopaedics

NEEDLE FASCIOTOMY FOR DUPUYTREN'S CONTRACTURE

British Orthopaedic Trainee Association (BOTA)



Abstract

Dupuytren's contracture is a common condition affecting 25% of men over the age of 65. With less advanced disease or with patients not suitable for a general or regional anaesthetic needle fasciotomy is the surgical option of choice.

The aim of this audit is to see whether the Department of Trauma and Orthopaedic surgery at Wirral University Teaching Hospital NHS Foundation Trust comply with the NICE guidelines.

All patients who underwent needle fasciotomy for Dupuytren's contracture at Wirral University Teaching Hospital NHS Foundation Trust from December 2008 and November 2010 were identified. The case notes of these patients were reviewed.

In a 23 month period 9 patients (13 fingers), underwent needle fasciotomy. There were 6 female and 3 male patients. The mean age at the time of surgery was 70 years (61-84 years). Of the 13 MCPJ contractures 12 had a full correction. At the PIPJ 5 of the 8 had a full correction. Of the one contracture affecting the DIPJ, this was fully corrected.

None of the patients undergoing needle fasciotomy had any complications recorded. At a minimum follow up 4 months and a mean follow up of 14 months, none of our patients have returned to the unit with recurrence of disease.

In our unit needle fasciotomy is a safe and effective in correcting deformity. To date we have no complications or recurrence. None of these patients have returned for further surgery. We are compliant with the NICE guidelines.