The outcome of surgical treatments for primary Dupuytren's disease--a systematic review.

There is no consensus on the most effective operation for primary Dupuytren's contracture. This systematic review evaluates the reported rates of recurrence and complications, as well as the strength of evidence, for individual procedures. The PubMed and EMBASE databases were searched for papers in English containing 'Dupuytren' in the citation. The initial search produced 2155 references, of which 69 papers met the study inclusion criteria. There was wide disparity in scoring systems, definition of recurrence and recording of complications. Follow-up ranged from 3 weeks to 13 years, and recurrence from 0 to 71%. There are only three Level I studies comparing surgical techniques for the treatment of primary Dupuytren's contracture, and the evidence does not support one procedure above another, other than to show a particularly high recurrence rate after needle fasciotomy. We propose a minimum data set for future studies.