Dupuytren’s disease of ring and little finger View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2002-06-01

AUTHORS

Peter Brenner

ABSTRACT

ObjectiveResection of fibrous digitopalmar connective tissues to improve finger function.IndicationsDupuytren’s disease in Tubiana’s stage >III. Partial fasciectomy: at any age, for localized involvement, unlimited degree of contracture, and for recurrences. Complete fasciectomy: extension lag <45° of an individual finger, favorable skin condition, and progressing Dupuytren’s disease.ContraindicationsPoor general health.State after stroke.Infection or eczema of hand.Excessive alcohol intake.Uncooperative patient.Relative: HIV infection.Surgical TechniqueAntegrade dissection of the fibrous tissue from palm to distal interphalangeal joint through a Y-shaped palmar incision or longitudinal digital incision interrupted by Z-plasties at the level of flexion creases. Dissection starts at the radial healthy side. For partial fasciectomy, the fibrous tissue is removed including a safety margin. During complete fasciectomy, the entire triangular palmar fascia including the vertical septae is excised.The so-called open palm technique is a particular form of a partial fasciectomy whereby transverse incisions are not closed as opposed to longitudinal incisions which are always sutured.ResultsIn a prospective study, 48/239 patients were followed up >2 years. Recurrence rate was 39.7% while hand function improved by 70–86% in ulnar type.Complications observed in a retrospective study (1982–1991) of 566 patients (two thirds partial, one third complete fasciectomy): wound healing disturbance 3%, hematoma 2.5%, vessel injury 1.2%, nerve injury 1.8%, infection 0.7%, persisting edema 0.7%, scar contracture 0.2%.87% of all recurrences appeared within 24 months. Their incidence after 2–10 years varied after partial or complete fasciectomy between 12.5 and 66%, and 21.4 and 39.7%, respectively. Only a small percentage of these needed a revision. More... »

PAGES

138

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00065-002-1044-x

DOI

http://dx.doi.org/10.1007/s00065-002-1044-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1028460836


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