Treatment durability of limited fasciectomy vs. percutaneous needle fasciotomy for Dupuytren's disease

Bente A van den Berge; Fatuma M A Omar; Paul M N Werker; Zhuozhao Zhan; Edwin R van den Heuvel; Dieuwke C Broekstra

doi:10.1097/PRS.0000000000011322

Treatment durability of limited fasciectomy vs. percutaneous needle fasciotomy for Dupuytren's disease

Plast Reconstr Surg. 2024 Jan 30. doi: 10.1097/PRS.0000000000011322. Online ahead of print.

Authors

Bente A van den Berge¹, Fatuma M A Omar², Paul M N Werker¹, Zhuozhao Zhan², Edwin R van den Heuvel², Dieuwke C Broekstra¹

Affiliations

¹ University of Groningen, University Medical Center Groningen, Department of Plastic Surgery, Groningen, the Netherlands.
² Eindhoven University of Technology, Department of Mathematics and Computer Science, Eindhoven, the Netherlands.

PMID: 38289897
DOI: 10.1097/PRS.0000000000011322

Abstract

Background: Patients with Dupuytren's disease (DD) are mostly surgically treated by percutaneous needle fasciotomy (PNF) or limited fasciectomy (LF), but data on time intervals to retreatment is lacking. We aimed to estimate the risk of retreatment within certain time periods after treatment with PNF and LF.

Methods: We used data of participants of a cohort study on the course of DD who were treated only with PNF or LF. Our primary outcome measure was time to retreatment of DD. We included sex, age at first treatment and having a first degree relative with DD as confounders in our analysis. We applied a bivariate gamma frailty model to estimate the risk of retreatment within 1,3,5, 10 and 20 years after treatment with PNF and LF.

Results: The time to retreatment was significantly shorter after treatment with PNF than after LF (Wald test 7.56, p<0.001). The estimated 10-year risk of retreatment for men who underwent their first treatment at a younger age and with a first degree relative with DD was 97% after PNF and 32% after LF. The estimated 10-year risk for women who underwent their first treatment at an older age without a first degree relative with DD was 20% after PNF and 6% after LF.

Conclusions: Our results show that the patients treated with PNF have a higher risk of retreatment. The results of this study could contribute to individualized information on the treatment durability in the future, which would improve patient counseling about the expected retreatment needs.