The Lateral Digital Flap for Dupuytren’s Fasciectomy at the Proximal Interphalangeal Joint – a Study of 84 Consecutive Patients

Abstract

Fasciectomy is the most common operation performed for Dupuytren’s disease. However, as the joint contracture increases, issues of skin deficiency following release become significant. For severe or recurrent disease dermafasciectomy is advised, but a digital transposition flap provides a viable alternative without the need for a skin graft for less-severe disease with moderate skin deficiency. A retrospective review identified 84 patients who had undergone this operation. The flap used was proximally based on the midlateral aspect of the finger allowing direct closure of the donor site. Ninety hands with 134 digits were operated on and 83% of the patients had a full correction. About 70% remained fully corrected at 1 year. All flaps were performed for proximal interphalangeal joint involvement. The mean pre-operative contracture was 34°, corrected postoperatively to 5°. The recurrence rate was 9%. Two percent of the patients had local infection but no flap necrosis was seen. A lateral digital transposition flap is a very stable operation for Dupuytren’s disease with moderate skin deficiency and our patients achieved favourable results when compared to other studies that used local flaps combined with skin graft.