Of 359 hands treated surgically for Dupuytren's contracture, 135 were
available for study after two years or more, often because of recurrence.
Of the sixty-five hands treated by excision of the involved fascia
(subtotal fasciectomy), 63 per cent had recurrences in the area operated on
but only 15 per cent had sufficient deformity to warrant another operation.
Of the forty-one hands treated by palmar fasciotomy, 43 per cent had
recurrent deformities severe enough to warrant further surgical treatment.
After palmar fasciotomy, improvement at the metacarpohalangeal joint
persisted; but, as expected, the deformity at the proximal interphalangeal
joint progressed just as it did in an untreated control group. The average
postoperative period of disability was fifty-nine days after fasciectomy
and twenty-one days after fasciotomy. Stiffness and hematoma occurred after
fasciectomy but were not observed after fasciotomy. A digital nerve was
severed during one fasciotomy and one fasciectomy. Excision of the involved
fascia, therefore, gave the best long-term results but was associated with
a higher incidence of postoperative complications.