Dupuytren's Contracture with Palpable Strand in Palmar Fascia

This protocol applies to Dupuytren's contracture in the specific clinical setting where a palpable strand is present in the palmar fascia — a finding that directly determines which interventions are appropriate and which are not.

The presence or absence of a palpable strand in the palmar fascia is a critical examination finding. Percutaneous needle fasciotomy is indicated for consideration in suitable patients — such as the elderly — when a palpable strand is confirmed. It is not indicated when no palpable strand can be identified.

In severe or refractory presentations, the structured protocol addresses salvage-level surgical approaches to the affected finger. The complete indications, sequencing, and criteria governing each option are detailed in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jhsg.2022.11.008

Consider the following for percutaneous needle fasciotomy: in the elderly patient with a palpable strand.

Percutaneous needle fasciotomy is not indicated when there is no palpable strand.

Consider salvage techniques in severe recurrent contracture when partial fasciectomy cannot generate improvement and in cases with vascular insufficiency or damaged sensation.

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