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Free vascular flaps

In severe cases of Dupuytren’s disease a free vascular flap may be preferred to treat the disease . Not many studies are conducted, but the idea is that there will...

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Percutaneous needle fasciotomy

Needle aponeurotomy is a minimally-invasive technique where the cords are weakened through the insertion and manipulation of a small needle. The cord is sectioned at as many levels as possible...

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Limited fasciectomy

The limited or selective fasciectomy removes the pathalogical tissue, and is commonly used around the world. During the treatment the patient is under regional or general anesthesia. Surgeons use a surgical tourniquet to prevent blood flow to the limb. The skin is often opened with a zig-zag incision but straight incisions with or without Z-plasty are also described- and may reduce damage to the neurovascular bundles (see below). After the incision is made, all diseased cords and fascia are excised.

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Wide awake fasciectomy

Three centres worldwide have published the results of limited/selective fasciectomy under local anesthesia (LA) with epinephrine but no tourniquet. The original description of the technique was in 2005 by Dr Denkler, a Plastic Surgeon, from San Francisco; his 60 case series clearly refuting several decades of surgical dogma that adrenaline cannot be used in digits, and indeed that Dupuytren's fasciectomy cannot be done under LA without a tourniquet. 

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