What are other treatment options?
There is a general tendency for surgeons to recommend minimal surgery (e.g… fasciotomy) for early disease, fasciectomy for established disease and more aggressive surgery (e.g… dermofasciectomy) for advanced or recurrent disease 6529287. Final outcome after surgery is worse in patients who have an earlier age of onset, severe PIP joint involvement, and small finger involvement 1284016. Surgery is usually recommended when MCP contractures progress to 30 degrees, when PIP contractures develop 1769986, or the patient develops a positive “table top test” 7060997, as shown here. Needle aponeurotomy may be performed when the fingers can’t be lifted from a tabletop; open surgery is reserved for contractures which prevent the palm from fully contacting a flat surface:
Table Top Tests
