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The only new developments to discuss here are:
- When to intervene:
There is no fixed angle of contracture where we decide to operate. The main advice we can give is – when the patient finds the contracture interferes with activities of daily living or hobbies.
- Are there any non-operative treatments?
Xiapex (Pfizer) is now licensed within the UK. International studies have demonstrated encouraging results. It therefore possible to treat certain patients without surgery. However patients must meet suitable criteria.
- What procedures are available?
Percutaneous or needle fasciotomy is an option but only for specific patients who have very palpable palmar cords. There is a much higher incidence of short to medium term recurrence
There is a debate about whether to perform a fasciectomy or dermo-fasciectomy in the younger patients with a strong diathesis of Dupytren’s disease. Overall we are undecided.
Video showing use of Xiapex:
More detailed information also available from the International Dupuytren Society.