Long-Term Results after Segmental Aponeurectomy for Dupuytren’s Disease

Moermans, Jean-Pierre

doi:10.1016/s0266-7681(96)80195-1

Cited by 60 publications

(33 citation statements)

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“…The type of operation does not appear to be related to the progression of Dupuytren disease. 3 Surgical complications occur intraoperatively, as well as during the early and late postoperative periods: digital nerve injury, vascular injury, skin flap "buttonholes," hematoma (seroma), swelling, infection, flare, wound dehiscence, recurrence, pseudoaneurysm, and inclusion cyst. 4 Awareness of these complications is necessary for hand therapy to proceed in a timely fashion to avoid postoperative stiffness.…”

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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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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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“…en V-Y, 7 múltiples pequeñas curvas, 8 transversales, 9 y diferentes combinaciones de incisiones transversales, longitudinales y colgajos locales. 2,[10][11][12] No existe un único diseño de incisión adaptable a todas las formas de presentación de la ED y, en general, cada caso debe ser evaluado de forma particular.…”

Section: Discussionunclassified

Colgajo comisural palmar: su utilidad en el abordaje de la enfermedad de Dupuytren con compromiso de dedos contiguos. [Commissural palmar flap: use in Dupuytren’s disease involving adjacent fingers]

Valbuena¹,

Pereira²,

Massa³

et al. 2015

Rev. Asoc. Arg. Ort. y Traumatol

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Re ci bi do el 15-10-2013. Acep ta do lue go de la eva lua ción el 15-1-2015. Co rres pon den cia:Dr. SEBASTIÁN E. VALBUENA valbuena.sebastian@gmail.com Re su menIn tro duc ción: El diseño de las incisiones en la enfermedad de Dupuytren es probablemente el detalle técnico más importante en el tratamiento quirúrgico. El objetivo de este trabajo es realizar una valoración retrospectiva de la utilidad del colgajo comisural palmar en el abordaje de la enfermedad de Dupuytren con compromiso de dedos contiguos. MaterialesyMétodos:Entre abril de 2009 y diciembre de 2012, los autores operaron a 32 pacientes con enfermedad de Dupuytren. Se incluyeron 12 pacientes con compromiso de, al menos, 2 dedos contiguos y el diseño de un colgajo comisural palmar. Se evaluaron entre los días 3-5, 15-21, 45-60 y a los 6 meses posoperatorios. Al final del seguimiento, se constataron las recidivas, la satisfacción y el puntaje QuickDASH. Resultados: Se realizaron 13 colgajos comisurales palmares en 12 pacientes, 6 manos derechas y 6 izquierdas. Los rayos contiguos afectados fueron el 4.° y 5.° dedos (8 casos), el 3.°, 4.° y 5.° dedos (3 casos), y el 3.° y 4.° dedos (un caso). La distancia promedio del colgajo comisural palmar comisura-vértice fue de 2,23 cm (rango 1,2-4,3) y la transversal, de 2,42 cm (rango 1,6-3,8). Siempre se pudo realizar la resección de las cuerdas patológicas y la fasciectomía parcial sin complicaciones intraoperatorias. Hubo una necrosis distal parcial, tratada con técnica de palma abierta. Conclusiones: El colgajo comisural palmar es de fácil disección y seguro a causa de su múltiple vascularización, permite una correcta visualización de las estructuras vasculonerviosas digitales y las bandas patológicas, útil en afección de dedos contiguos. patients with Dupuytren's disease were operated on by the authors. Twelve patients with at least 2 adjacent fingers involvement and the design of a palmar commissural flap. The flaps were evaluated at days 3-5, 15-21, 45-60, and 6 months post-surgery. At the end of the follow-up, recurrence, satisfaction and Quick Dash score were evaluated.Results: Thirteen palmar commissural flaps were performed in 12 patients (6 right hands and 6 left hands). The affected adjacent rays were the 4th and 5th fingers (8 cases); the 3rd, 4th and 5th fingers (3 cases), and the 3rd and 4th fingers (one case). Average distances of the palmar commissural flap, commissure-vertex was 2.23 cm (range 1.2-4.3), and that of the transverse 2.42 cm (range 1.6 to 3.8). In all cases it was performed according to preoperative planning resection of pathological cords and partial fasciectomy. One case presented distal necrosis, which was treated with open palm technique. Conclusions:The palmar commissural flap can identify both the digital pedicle as pathological structures. Its vascularization makes it a safe and easy flap dissection.

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“…In this case, Moermans recommends at least a partial excision of the diseased cords (21). Thus, the election of a therapeutic approach appropriate for a given patient is of great importance.…”

Section: Discussionmentioning

confidence: 99%

Early Results of Open Fasciotomy as a Treatment of Dupuytren's Disease in Elderly Patients

Jabłecki¹,

Kaczmarzyk²,

Domanasiewicz³

et al. 2007

Polish Journal of Surgery

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The demand for treatment of Dupuytren's disease by a procedure of limited invasiveness and quick recovery is increasing in accordance with aging of the Polish population. Such a demand is fulfilled by different types of fasciotomy (open, percutaneous needle fasciotomy). The aim of the study was to asses the early results of the open fasciotomy in elderly patients. Material and methods. We treated 38 patients (61 fingers) whose mean age was 72 (SD 12) by open fasciotomy; 43 fingers presented stage III Tubiana contracture, 18 stage IV. The pre-operative total passive extension deficit was 123° (78° for stage III group, 111° for stage IV group). All the procedures were performed in outpatient setting. Patients used splint for 5 days, then performed finger -extension exercises and were encouraged to use their hands normally after 1 week. Results. The evaluation of the results was performed 4 weeks post-op. The greatest improvement in both of the groups was noted in MCP joint -80% and in PIP joint -48%, this difference is statistically significant. The general improvement ratio was 76%, greater in stage III group -82% whereas in stage IV group 69%, but this difference was not statistically significant. All of the wounds healed up to 3 weeks, no complications were observed. Conclusion.The open fasciotomy is a recommendable short term treatment in patients of advanced age, suffering from stage III and stage IV of Dupuytren's disease.

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Long-Term Results after Segmental Aponeurectomy for Dupuytren’s Disease

Cited by 60 publications

References 3 publications

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

Colgajo comisural palmar: su utilidad en el abordaje de la enfermedad de Dupuytren con compromiso de dedos contiguos. [Commissural palmar flap: use in Dupuytren’s disease involving adjacent fingers]

Early Results of Open Fasciotomy as a Treatment of Dupuytren's Disease in Elderly Patients

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Long-Term Results after Segmental Aponeurectomy for Dupuytren’s Disease

Cited by 60 publications

References 3 publications

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

Colgajo comisural palmar: su utilidad en el abordaje de la enfermedad de Dupuytren con compromiso de dedos contiguos. [Commissural­ palmar­ flap:­ use­ in­ Dupuytren’s­ disease­ involving­ adjacent­ fingers]

Early Results of Open Fasciotomy as a Treatment of Dupuytren's Disease in Elderly Patients

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Colgajo comisural palmar: su utilidad en el abordaje de la enfermedad de Dupuytren con compromiso de dedos contiguos. [Commissural palmar flap: use in Dupuytren’s disease involving adjacent fingers]