Current concepts in Dupuytren's disease.

The last few years have seen a number of significant studies in Dupuytren's disease that may result in a paradigm shift in the management of this condition. This review article assesses recent therapeutic studies from January 2010 to August 2012. These were rated for levels of evidence, trial quality using the Jadad and Detsky scales, and graded by strength of recommendation. Significant studies include the success of Phase III trials of injectable collagenase (CORD I and II), that may radically alter the practice of Dupuytren's. Other highlights include randomized controlled trials that address the ongoing debate on needle fasciotomy vs limited fasciectomy, and also the utility of night-time post-operative splinting. Furthermore, the concept of "clinically important differences" in Dupuytren's outcomes research is considered in the context of the CORD I trial. The implications of these studies for current practice and future research are discussed.