Authors at the University of Cincinnati conducted a twofold study, firstly to determine whether controversyexisted among the American Society for Surgery of the Hand (ASSH), specifically targeting members in the surgical treatment on concurrent Carpal Tunnel Release (CTR) and Dupuytren's disease.
Secondly, the authors reviewed their own experiences when performing CTR and Dupuytren's fasciectomy simultaneously, specifically identifying complications.
1,399 active members of the ASSH were emailed a survey, in order to collate the information required for this study. In addition, a review was performed on 70 patients who had simultaneous CTR and Dupuytren's fasciectomy. Two other groups, with 50 patients in each who had CTR or Dupuytren's fasciectomy alone were also identified to serve as a comparison.
50% of ASSH members replied to the survey. Approximately half the surgeons reported they would perform these procedures simultaneously, and the other half were not likely to perform both surgeries due to the potential development of complex regional syndrome and possible post-operative stiffness.
12 out of the 70 patients developed minor complications, none of whom required treatment surgery. Two patients experienced transient pain and one patient experienced stiffness.
Within the ASSH, there is still controversy regarding these two procedures being performed simultaneously.
Based on this study's findings, the authors recommend performing both CTR and Dupuytren's fasciectomy at the same surgical session, therefore dispelling any myth that simultaneous surgery had an increased complication risk.
Mr Mike Hayton agrees with the conclusions and routinely performs and will continue to perform both surgeries simultaneously.
Lilly. S.I. and Stern. P.J.
Journal of Hand Surgery 2010;35A:754-759. The Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.