Dupuytren's Disease of the Radial Side of the Hand

The systematic examination and recording, ray by ray, using the author's method of assessment of Dupuytren's disease have revealed that there are more Dupuytren's disease cases affecting the radial side of the hand than usually believed. The aponeurotic structures of the thumb and first web space are described. The location of diseased tissue coincides with the normal aponeurotic structures. Radial involvement alone is rare; most often, radial-side involvement is associated with ulnar-side involvement. Radial-sided lesions in the older patient progress slowly and rarely require surgery. In the younger patient, however, progress can be rapid, can lead to significant contractures, and recurrence after partial fasciectomy is frequent. Surgical management of these aggressive forms requires a large approach and an extensive excision. These cases are the best indications for dermofasciectomies.