Dupuytren Disease: Planning Surgical Approaches
Abstract
Dupuytren disease is a fibroproliferative disorder of the palmar fascia that causes flexion contractures and functional impairment. Its course is variable, and recurrence rates are high; therefore, surgery remains the mainstay of treatment for patients with advanced disease. The anatomical complexity of the palmodigital region and the heterogeneous presentation of the disease make careful planning of the surgical approach essential to optimizing outcomes. Knowledge of the anatomy of the palmar aponeurosis and its digital extensions allows the cords and their relationship to the neurovascular structures to be identified, which is crucial for safe resection. The choice of skin incision should be based on the extent of the disease, the number of digits and joints involved, the anatomical pattern, and the condition of the skin, rather than on the degree of contracture. The main incision options (longitudinal, transverse, and combined) as well as dermofasciectomy in selected cases are discussed, together with the authors’ preferences. Although minimally invasive alternatives are available, fasciectomy continues to provide more durable results. Appropriate planning can improve exposure, reduce complications, and optimize functional outcomes.Downloads
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