{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:45:37Z","timestamp":1787755537950,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Essential Surgical Techniques"],"abstract":"\n Background:<\/jats:title>\n \n Percutaneous needle fasciotomy (PNF) is a minimally invasive treatment option for mild to moderate Dupuytren contractures in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints, and the procedure requires limited resources. Multiple contractures can be treated during the same session, and the treatment is considerably easier for the patient and requires a minimum of rehabilitation compared with limited fasciectomy\n 1<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Description:<\/jats:title>\n PNF can be performed in a regular outpatient clinic in most cases. With the patient in a reclined position, the cord of the contracted joint is tensioned by passive extension and is divided percutaneously with a 25-gauge needle under local anesthesia. The immediate treatment effect in terms of reduction of the contracture is readily assessed, and PNF can be performed at additional levels if needed.<\/jats:p>\n <\/jats:sec>\n \n Alternatives:<\/jats:title>\n \n \n \n \n Collagenase\n Clostridium histolyticum<\/jats:italic>\n (CCH; Xiaflex).\n <\/jats:p>\n <\/jats:list-item>\n \n Total or partial fasciectomy.<\/jats:p>\n <\/jats:list-item>\n \n Dermofasciectomy.<\/jats:p>\n <\/jats:list-item>\n \n Amputation (in severe cases after multiple other procedures).<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Rationale:<\/jats:title>\n \n Local treatment with injection of CCH (Xiaflex) in the Dupuytren cord enables rupture of the cord similar to that after PNF\n 2<\/jats:sup>\n . Both CCH and PNF are minimally invasive treatments with obvious advantages compared with open surgery\n 3<\/jats:sup>\n , and they seem to have the same intermediate-term outcome\n 4\u20136<\/jats:sup>\n . However, CCH treatment is considerably more expensive than PNF and requires 2 visits by the patient to the outpatient clinic instead of 1\n 7<\/jats:sup>\n . CCH has also been reported to have more complications than PNF\n 2,8<\/jats:sup>\n . Furthermore, multiple (>4) joint contractures\n 9<\/jats:sup>\n can be treated by PNF at the same time. In the author\u2019s experience, even bilateral contractures can be treated at the same session if requested by the patient. As the number of patients treated with CCH and PNF has increased, there has been a corresponding decrease in more invasive procedures\n 10<\/jats:sup>\n ; however, open surgery will probably always remain an option in more severe cases or as a secondary procedure after recurrence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.st.18.00047","type":"journal-article","created":{"date-parts":[[2019,2,15]],"date-time":"2019-02-15T06:48:11Z","timestamp":1550213291000},"page":"e6","source":"Crossref","is-referenced-by-count":18,"title":["Percutaneous Needle Fasciotomy for Dupuytren Contracture"],"prefix":"10.2106","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5252-8710","authenticated-orcid":false,"given":"Joakim","family":"Str\u00f6mberg","sequence":"first","affiliation":[{"name":"Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden"},{"name":"Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, M\u00f6lndal, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,3,26]]},"reference":[{"issue":"5","key":"bib1-20230812","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.jhsa.2006.02.021","article-title":"A comparison of the direct outcomes of percutaneous needle fasciotomy and limited fasciectomy for Dupuytren\u2019s disease: a 6-week follow-up study","volume":"31","author":"van Rijssen","year":"2006","journal-title":"J Hand Surg Am."},{"issue":"7","key":"bib2-20230812","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1177\/1753193417711594","article-title":"Ultrasonographic examination of the ruptured cord after collagenase treatment or needle fasciotomy for Dupuytren\u2019s contracture","volume":"42","author":"Str\u00f6mberg","year":"2017","journal-title":"J Hand Surg Eur Vol."},{"issue":"8","key":"bib3-20230812","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1016\/j.jhsa.2015.04.036","article-title":"Dupuytren contracture recurrence following treatment with collagenase Clostridium histolyticum (CORDLESS [Collagenase Option for Reduction of Dupuytren Long-Term Evaluation of Safety Study]): 5-year data","volume":"40","author":"Peimer","year":"2015","journal-title":"J Hand Surg Am."},{"issue":"6","key":"bib4-20230812","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1177\/1753193415617385","article-title":"One-year results of needle fasciotomy and collagenase injection in treatment of Dupuytren\u2019s contracture: a two-centre prospective randomized clinical trial","volume":"41","author":"Scherman","year":"2016","journal-title":"J Hand Surg Eur Vol."},{"issue":"5","key":"bib5-20230812","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.jhsa.2017.03.003","article-title":"Injectable collagenase versus percutaneous needle fasciotomy for Dupuytren contracture in proximal interphalangeal joints: a randomized controlled trial","volume":"42","author":"Skov","year":"2017","journal-title":"J Hand Surg Am."},{"issue":"9","key":"bib6-20230812","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/j.jhsa.2016.06.014","article-title":"Comparison of treatment outcome after collagenase and needle fasciotomy for Dupuytren contracture: a randomized, single-blinded, clinical trial with a 1-year follow-up","volume":"41","author":"Str\u00f6mberg","year":"2016","journal-title":"J Hand Surg Am."},{"issue":"11","key":"bib7-20230812","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1016\/j.jhsa.2011.08.004","article-title":"Cost-effectiveness of open partial fasciectomy, needle aponeurotomy, and collagenase injection for Dupuytren contracture","volume":"36","author":"Chen","year":"2011","journal-title":"J Hand Surg Am."},{"issue":"5","key":"bib8-20230812","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.hansur.2017.07.002","article-title":"Complications after treating Dupuytren\u2019s disease. 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