Dupuytren’s Disease Treated by Palmar Fasciectomy and an Open Palm Technique

Shaw, Daigee; Wise, D.I.; Holms, W.

doi:10.1016/s0266-7681(96)80051-9

Cited by 31 publications

(11 citation statements)

References 8 publications

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“…Total active motion data and change in extension values are also comparable with that in the literature, for both primary and recurrent disease [12,27,30,32]. One possible explanation for the slightly lower TAM values in our Wide-Awake group is that there were four patients in the Wide-Awake group who had surgery for recurrent disease, where there was only one patient in the general anesthetic group who had surgery for recurrent disease (see Table 1).…”

Section: Discussionsupporting

confidence: 83%

The Wide-Awake Approach to Dupuytren's Disease: Fasciectomy under Local Anesthetic with Epinephrine

Nelson

Higgins

Conrad

et al. 2009

Hand (New York, N,Y.)

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The Wide-Awake Approach to Dupuytren's contracture involves fasciectomy under local anesthetic with epinephrine and no tourniquet. The goal of this study is to show that the Wide-Awake Approach produces equivalent outcomes to fasciectomy under general anesthetic with a tourniquet, with fewer risks to the patient. A multicenter retrospective review was conducted on 111 patients with fasciectomies under local or general anesthetic between 2001 and 2007. Data on patient demographics, comorbidities, cost, as well as range of motion was collected and evaluated using Microsoft Excel and SAS. Of 148 fingers, 102 were treated under local and 46 under general anesthetic. The average postoperative Total Active Motion (TAM) for general anesthetic patients was 199.0 ± 29.6 (D5), 223.9 ± 29.3 (D4), 234.6 ± 14.6 (D3), and 246.7 ± 14.4 (D2). The average postoperative TAM for local anesthetic patients was 168.3 ± 62.2 (D5), 195.9 ± 67.5 (D4), 173.0 ± 72.6 (D3), and 177.5 ± 31.8 (D2). There were no significant differences between any of these individual groups (p = 0.09, 0.26, 0.12, and 0.20, respectively); however, when pooled, the overall TAM was significantly greater in the general anesthesia group (222.0 ± 29.7 vs. 186.0 ± 63.0, p = 0.002.). Complication rates and types were similar with both techniques. The Wide-Awake Approach to Dupuytren's contracture avoids general anesthetic risks and has cost benefits to healthcare providers. Although it yields similar range of motion outcomes to fasciectomy performed under general anesthesia, total active motion may be better with fasciectomy done under general anesthesia.

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Section: Discussionsupporting

confidence: 83%

The Wide-Awake Approach to Dupuytren's Disease: Fasciectomy under Local Anesthetic with Epinephrine

Nelson

Higgins

Conrad

et al. 2009

Hand (New York, N,Y.)

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“…The cords were located most often in the ring and little finger. 3,7,8,13 If the parameters gender and family predisposition were included, the distribution remained the same. The overall rate of complications was 26%.…”

Section: Discussionmentioning

confidence: 99%

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

Coert¹,

Nerin²,

Meek³

2006

Annals of Plastic Surgery

101

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Many different surgical techniques are still being used for Dupuytren disease. The outcome of 558 consecutive operations with 1 technique was reviewed. Distinct subgroups were made to detect risk factors for a poor outcome and complications. The mean follow-up time was 7.3 years. Younger patients (first surgery before 45 years) were operated significantly more than older patients (after 45 years). Results of contracted proximal interphalangeal (PIP) joints were significantly worse than other joints. The overall complication rate was 26%. Nerve lesions occurred in 7.7%. Young age proved to be a prognostic factor for the total number of operations. The contracted PIP joints will lead to more complications and poorer result. The risk at nerve lesion, necrosis, and infection are higher for recurrent surgery. These findings can be used in advising patients.

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“…Percentage change as a measure was used in 19 studies [ 17 , 28 , 30 , 40 – 44 , 50 – 52 , 59 , 66 – 68 , 90 , 91 , 96 , 99 ] with 3 reporting it as their sole outcome measure [ 52 , 90 , 91 ]. Four studies [ 20 , 39 , 45 , 57 , 58 , 78 , 89 , 98 , 99 ] presented data as differences or graphs with 2 authors using their chosen ROM outcome as their only measure [ 20 , 39 , 45 , 57 ].…”

Section: Resultsmentioning

confidence: 99%

“…Other grading systems used were Thomine improvement coefficient [ 57 , 89 ], Honner classification [ 58 ] and Strickland and Glogovac method [ 78 ].…”

Section: Resultsmentioning

confidence: 99%

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What are we measuring? A critique of range of motion methods currently in use for Dupuytren’s disease and recommendations for practice

Pratt

Ball

2016

BMC Musculoskelet Disord

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BackgroundRange of motion is the most frequently reported measure used in practice to evaluate outcomes. A goniometer is the most reliable tool to assess range of motion yet, the lack of consistency in reporting prevents comparison between studies. The aim of this study is to identify how range of motion is currently assessed and reported in Dupuytren’s disease literature. Following analysis recommendations for practice will be made to enable consistency in future studies for comparability. This paper highlights the variation in range of motion reporting in Dupuytren’s disease.MethodsA Participants, Intervention, Comparison, Outcomes and Study design format was used for the search strategy and search terms. Surgery, needle fasciotomy or collagenase injection for primary or recurrent Dupuytren’s disease in adults were included if outcomes were monitored using range of motion to record change. A literature search was performed in May 2013 using subject heading and free-text terms to also capture electronic publications ahead of print. In total 638 publications were identified and following screening 90 articles met the inclusion criteria. Data was extracted and entered onto a spreadsheet for analysis. A thematic analysis was carried out to establish any duplication, resulting in the final range of motion measures identified.ResultsRange of motion measurement lacked clarity, with goniometry reportedly used in only 43 of the 90 studies, 16 stated the use of a range of motion protocol. A total of 24 different descriptors were identified describing range of motion in the 90 studies. While some studies reported active range of motion, others reported passive or were unclear. Eight of the 24 categories were identified through thematic analysis as possibly describing the same measure, ‘lack of joint extension’ and accounted for the most frequently used.ConclusionsPublished studies lacked clarity in reporting range of motion, preventing data comparison and meta-analysis. Percentage change lacks context and without access to raw data, does not allow direct comparison of baseline characteristics. A clear description of what is being measured within each study was required. It is recommended that range of motion measuring and reporting for Dupuytren’s disease requires consistency to address issues that fall into 3 main categories:-Definition of termsProtocol statementOutcome reportingElectronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-0884-3) contains supplementary material, which is available to authorized users.

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Dupuytren’s Disease Treated by Palmar Fasciectomy and an Open Palm Technique

Cited by 31 publications

References 8 publications

The Wide-Awake Approach to Dupuytren's Disease: Fasciectomy under Local Anesthetic with Epinephrine

The Wide-Awake Approach to Dupuytren's Disease: Fasciectomy under Local Anesthetic with Epinephrine

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

What are we measuring? A critique of range of motion methods currently in use for Dupuytren’s disease and recommendations for practice

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