Comparative Surgical Management of Dupuytren´s Contracture: Percutaneous Needle Aponeurotomy vs Limited Open Fasciectomy
Pintado Gonzalo MD1*, Aedo Daniel MD1, Rodríguez Germán MD2, Fernández María MD2
1Hospital Universitario del Henares, Av. de Marie Curie, 0, 28822 Coslada, Madrid, Spain.
2Universidad Francisco de Vitoria, M-515, km 1, 800, 28223 Pozuelo de Alarcon, Madrid, Spain.
*Corresponding Author: Pintado Gonzalo MD, Hospital Universitario del Henares, Av. de Marie Curie, 0, 28822 Coslada, Madrid, Spain.
https://doi.org/10.58624/SVOAOR.2025.05.021
Received: July 23, 2025
Published: December 02, 2025
Citation: Gonzalo P, Daniel A, German R, María F. Comparative Surgical Management of Dupuytren´s Contracture: Percutaneous Needle Aponeurotomy vs Limited Open Fasciectomy. SVOA Orthopaedics 2025, 5:6, 126-133. doi: 10.58624/SVOAOR.2025.05.021
Abstract
Introduction: The optimal treatment for Dupuytren’s disease remains debated. While limited open fasciectomy (LOF) is considered the gold standard, it is associated with higher complication rates, greater postoperative pain, and longer recovery periods. This study compares clinical and functional outcomes, recurrence rates, complications, and discharge timing between percutaneous needle aponeurotomy (PNA) and LOF.
Materials and Methods: We conducted a retrospective review of 98 patients treated for Dupuytren’s disease between 2016 and 2023. Patients underwent either PNA or LOF and were assessed using the Tubiana and Michon classification, URAM, and MHQ questionnaires. Variables included joint involvement, follow-up duration, complications, and recurrence. Statistical analysis was performed using STATA v.15, with significance set at p < 0.05.
Results: Patients in the PNA group showed greater improvement in Tubiana staging (mean 1.5 vs. 1.2 in LOF, p = 0.037), shorter follow-up to discharge (mean 4.85 vs. 23.13 weeks, p < 0.001), and fewer follow-up visits. Overall complication rates were 24% in LOF and 17% in PNA. Major complications were more frequent in the LOF group, including nerve injuries and one amputation. PNA patients had fewer skin injuries and no severe adverse events. Functional outcomes favored PNA in daily activity (MHQ: 90.5 vs. 78.4; p = 0.046) and pain scores (MHQ: 18.4 vs. 33.6; p = 0.041). Recurrence rates were comparable.
Conclusions: PNA demonstrated favorable clinical and functional outcomes with significantly lower morbidity and faster recovery compared to LOF. It offers a safe and effective minimally invasive alternative for selected patients with Dupuytren’s disease.
Keywords: Dupuytren’s Disease Treatment, Percutaneous Aponeurotomy, Limited Fasciectomy