Dupuytren's contracture: a comparative study of fasciectomy and dermofasciectomy in one hundred patients.

This study reviews one hundred patients with Dupuytren's disease treated surgically by the Derby Hand Unit between January 1975 and September 1981. One hundred and twenty-eight operations were assessed with a follow-up period from nine months to ninety months, average thirty-eight months. In thirty-five patients the overlying skin was excised and replaced by a full-thickness skin graft (dermofasciectomy). The remaining patients were treated by fasciectomy without skin excision. The overall recurrence rate after surgery was found to be 46.5%. However skin excision and replacement following fasciectomy prevented any appreciable, if not all recurrence of Dupuytren's tissue. The function of the hand was assessed with regard to the improvement in flexion contracture; ability to flex the finger to the distal palmar crease; sensibility of the replaced skin; time to return to work and full activity. It was concluded that skin replacement did not jeopardize hand function.