Percutaneous Aponeurotomy and Lipofilling (PALF): A Regenerative Approach to Dupuytren Contracture

Clin Plast Surg. 2015 Jul;42(3):375-81, ix. doi: 10.1016/j.cps.2015.03.006. Epub 2015 Apr 28.

Abstract

Dupuytren disease is a progressive fibroproliferative disorder, which leads to flexion contractures of the digits. A minimally invasive technique consisting of an extensive percutaneous aponeurotomy of the cord with a needle combined with lipofilling is presented. The selective cutting of the cords under continuous tension disintegrates the cords while sparing the looser neurovascular bundles. Subsequently, lipoaspirate is injected subcutaneously. The authors' prospective results show a significantly shorter recovery time and less overall complications in this technique when compared with open surgery, while no significant difference was observed in the extent of immediate contracture correction and in the recurrence rate at 1 year follow-up.

Keywords: Dupuytren disease; Fat grafting; Lipofilling; Minimally invasive; Needle aponeurotomy; Needle fasciotomy.

Publication types

  • Review

MeSH terms

  • Adipose Tissue / cytology
  • Adipose Tissue / transplantation*
  • Dupuytren Contracture / physiopathology
  • Dupuytren Contracture / surgery*
  • Fasciotomy*
  • Humans
  • Needles
  • Regeneration
  • Stem Cell Transplantation
  • Tissue Transplantation