Surgical Incision Clinical Trial
Official title:
Tolerance and Efficacy Study of Second-line Surgery After Percutaneous Needle Aponeurotomy for Dupuytren's Disease. URAM 3
As part of a graduated medical-surgical strategy, and in our practice, surgery for Dupuytren's disease appears as a second-line treatment indicated in a situation of failure after treatment with percutaneous needle aponeurotomy.The results of second-line surgery in terms of safety and efficacy have not been specifically evaluated in patients who underwent failed percutaneous needle aponeurotomy. This evaluation nevertheless appears necessary for the validation of a medical-surgical strategy during Dupuytren's disease.
Dupuytren's disease is characterised by retractile fibrosis of the superficial palmar
aponeurosis that can result in irreversible flexing of the fingers and long-term disability.
The treatment of Dupuytren's disease, whether medical or surgical, remains symptomatic. It is
based in Europe on percutaneous needle aponeurotomy and surgical aponeurectomy. Its
objectives are the reduction of the deformity of the fingers in flexum, and that of the
incapacity that generates the illness. Percutaneous needle aponeurotomy for Dupuytren's
disease was developed by Jean-Luc Lermusiaux in 1972 in the Rheumatology Department of the
Lariboisière Hospital in Paris. Its efficiency, its tolerance, its simplicity, its low cost
and the possibility of repeating it make it a benchmark treatment. Percutaneous needle
aponeurotomy is, for many, if the existence of this technique is known and understood, the
first-line treatment of Dupuytren's disease.
As part of a graduated medical-surgical strategy, and in our practice, surgery for
Dupuytren's disease appears as a second-line treatment indicated in a situation of failure
after treatment with percutaneous needle aponeurotomy. The safety and efficacy of the surgery
was evaluated in the context of a first-line treatment of Dupuytren's disease. The results of
second-line surgery in terms of safety and efficacy have not been specifically evaluated in
patients who underwent failed percutaneous needle aponeurotomy. This evaluation nevertheless
appears necessary for the validation of a medical-surgical strategy during Dupuytren's
disease.
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