Dermofasciectomy

Operative excision of the diseased palmar fascia together with the overlying skin, with reconstruction by full-thickness skin graft. Reserved for recurrent disease and for primary surgery in the strongly diathetic patient. Reduces recurrence on the rationale that diseased fascia regenerates beneath unaffected skin but is markedly less likely to do so beneath a graft.

Related terms

• Procedure

  Limited fasciectomy

  Open surgical excision of the diseased palmar and digital fascia through a Bruner-zigzag or longitudinal-Z-plasty incision, with preservation of normal fibres. The contemporary operative workhorse for Dupuytren's contracture. Lower five-year recurrence than percutaneous needle fasciotomy at the cost of greater up-front morbidity, longer recovery, and a higher rate of nerve and vessel injury.

• Procedure

  Percutaneous needle fasciotomy

  Office-based percutaneous division of the Dupuytren cord with a small-bore (typically 25-gauge) needle under skin-wheal local anaesthesia, indicated for palpable pretendinous-cord contracture in selected primary disease. Reintroduced in the late 1970s by the French rheumatologist Lermusiaux. Shorter recovery and higher recurrence than limited fasciectomy.

• Condition

  Dupuytren's disease

  Benign progressive fibroproliferative disorder of the palmar and digital fascia, classified by WHO 2020 as a palmar-type fibromatosis. Characterised by myofibroblast-driven formation of nodules and cords in the palmar aponeurosis, leading to progressive flexion contracture of the digits, most commonly the ring and little fingers.

Articles mentioning this term

1. FESSH preparation · 5 May 2026

   Dupuytren's disease

   An expert synthesis of Dupuytren's disease — anatomy, the McFarlane cord pattern, the contemporary treatment landscape after the European withdrawal of collagenase, and the parallel consensus definitions of recurrence — for FESSH candidates and consultant peers.

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