Treatment of Recurrent Dupuytren Disease

Abstract

Treatment of recurrent Dupuytren disease is challenging. Multiple options exist, each having relative benefits and weaknesses. Choice for optimal treatment is made on a case-by-case basis, with shared decision making with the patient. Percutaneous and enzymatic techniques are best reserved for patients with well-defined recurrent disease and offer the benefit of quicker recovery with minimal or no scarring. Surgical treatments have higher risks of neurovascular injury and scarring, but lower recurrence rates. Staged continuous passive elongation followed by dermofasciectomy may lower neurovascular injury and improve outcomes. Salvage procedures may be necessary in patients with poor tissue beds and neurovascular compromise.

Keywords: Aponeurotomy; Collagenase Clostridium histolyticum; Continuous passive elongation; Dermofasciectomy; Dupuytren disease; Outcomes; Recurrence.