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Unité Rhumatologique des affections de la Main, Hopital Lariboisière, F-75010, Paris, France. henrilel@noos.fr
Dupuytren contracture or disease of the hand is the retraction of the palmar aponeurosis. Its course is progressive and leads to an irreducible flexion deformity of one or more fingers. Early diagnosis is necessary for the table test, which determines the need for treatment. Needle aponeurotomy should be the first option treatment. This minimally invasive outpatient procedure minimizes sick leave and does not require immobilization or physical therapy. Several studies confirmed the short- and intermediate-term effectiveness of this treatment and the minimal side effects when performed by experienced operators. Multiple procedures for extensive disease (several knots) can be performed in the hospital. Close medical and surgical collaboration is necessary for treatment of severe forms, treatment failures, and multiple recurrences.
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