Work

Microscopic Fasciectomy in Dupuytren Disease: Early Clinical Outcomes and Technical Advantages—A District General Hospital Experience

Year: 2026

Type: article

Abstract: Purpose: This study aimed to compare the early postoperative outcomes of microscopic and open fasciectomy for Dupuytren contracture, with a focus on joint correction, residual deformity, survivorship, functional outcomes, and technical benefits. Methods: This retrospective review included 40 patients (120 joints) who underwent fasciectomy between January 2023 and January 2025. Microscopy was performed in 21 cases (52.5%). Data were collected on demographics, surgical details, before surgery and postoperative joint angles, residual deformity (defined as >20° at 15-24 weeks), predictors via logistic regression, Kaplan-Meier survivorship, Quick Disabilities of the Arm, Shoulder, and Hand scores, complications, learning curve for microscopy, and surgical staff surveys. Results: The mean age of the patients was 66 years, and 80% were men. The little finger (51.7%) and proximal interphalangeal joints (52.5%) were the most affected joints. Open fasciectomy targeted more severe preoperative contractures (mean, 54° vs 39°) and yielded greater absolute corrections (53° vs 38°), especially at the metacarpophalangeal joints. Microscopy showed lower residual deformity rates (20% vs 38%) and better correction maintenance with higher survivorship (72.5% overall). Multivariate analysis identified hand therapy sessions as a key predictor of residual deformity and microscopy-trended protective effect. The functional scores averaged 16, with no differences by technique. Complications occurred in 7.5% of the cases, with no notable difference between the groups. Microscopy's learning curve demonstrated increased efficiency over time, alongside intraoperative benefits, such as improved precision and ergonomics. Conclusions: Early postoperative outcomes suggest that microscopic fasciectomy may offer modest short-term advantages in maintaining correction, with lower residual deformity, comparable functional outcomes, and a relatively rapid learning curve. Long-term studies are needed to establish whether these early findings support the broader adoption of microscopic techniques in hand surgery with structured training. Type of study/level of evidence: Therapeutic III.

Source: Journal of Hand Surgery Global Online

DOI: 10.1016/j.jhsg.2026.100955

Authors: Arfaz Shaik, Umar Hayat, Mustafa Al-Saadi, Chukwuemeka Amamilo, Islam Hamarsheh, Arvind Mohan

Institution: Croydon University Hospital

Language: English

Topic: Dupuytren's Contracture and Treatments

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500