ePlasty: Vol. 10
Surgical Complications Associated With Fasciectomy for Dupuytren's Disease: A 20-Year Review of the English Literature
Keith Denkler, MD

UCSF Divison of Plastic Surgery, 275 Magnolia Ave, Larkspur, CA 94939. Dr Denkler is in private practice also.

Correspondence: kdenklermd@hotmail.com

Objective: Excisional surgery is the mainstay of treatment of Dupuytren's disease. Although outcomes are generally good, complications are common. The objective of this study was to evaluate intraoperative and postoperative complications associated with fasciectomy for Dupuytren's disease. Methods: A literature search was conducted to identify published, original research that reported surgical complications associated with fasciectomy from 1988 to 2008. Search results were manually evaluated for relevance. Complication rates according to types of disease (primary or recurrent disease) and according to time (intraoperative vs postoperative) and type were collated. Results: A total of 143 articles were identified; 41 met inclusion criteria, and of these, 28 reported overall surgical complication rates ranging from 3.6% to 39.1%. Major complications occurred in 15.7%, including digital nerve injury 3.4%, digital artery injury 2%, infection 2.4%, hematoma 2.1%, and complex regional pain syndrome 5.5%. Other common, more minor injuries included flare reaction in 9.9%, wound healing complications in 22.9%, and a range of other complications. In the few (n = 3) studies in which primary and recurrent diseases were directly compared, digital nerve injuries and  .......