This 2011 current concepts review by Desai and Hentz surveys the full treatment landscape for Dupuytren disease — from percutaneous needle aponeurotomy and open fasciectomy to regional fasciectomy and dermofasciectomy — and evaluates the newly FDA-approved collagenase clostridium histolyticum (Xiaflex) as the first viable nonsurgical option.
When evaluating a Dupuytren patient, tailor surgical approach to disease stage and patient factors: MCP contractures ≥30° or any symptomatic PIP contracture warrant intervention, with PNA favored in elderly/high-comorbidity patients (accepting higher recurrence) and regional fasciectomy for primary cases requiring durable correction.
Collagenase (Xiaflex) is now a viable office-based alternative, but counsel patients that PIP recurrence is substantial at 8 years and that small-finger cord injection carries the highest risk of tendon rupture.
This 2011 current concepts review by Desai and Hentz surveys the full treatment landscape for Dupuytren disease — from percutaneous needle aponeurotomy and open fasciectomy to regional fasciectomy and dermofasciectomy — and evaluates the newly FDA-approved collagenase clostridium histolyticum (Xiaflex) as the first viable nonsurgical option.
When evaluating a Dupuytren patient, tailor surgical approach to disease stage and patient factors: MCP contractures ≥30° or any symptomatic PIP contracture warrant intervention, with PNA favored in elderly/high-comorbidity patients (accepting higher recurrence) and regional fasciectomy for primary cases requiring durable correction.
Collagenase (Xiaflex) is now a viable office-based alternative, but counsel patients that PIP recurrence is substantial at 8 years and that small-finger cord injection carries the highest risk of tendon rupture.