The long-term results of closed palmar fasciotomy in the management of dupuytren's contracture

Bryan, AJ; Ghorbal, M

doi:10.1016/0266-7681(88)90079-4

Cited by 43 publications

(28 citation statements)

References 2 publications

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“…The last three decades have seen a resurgence of percutaneous fasciectomy, particularly in Europe. [2][3][4][5][6] Percutaneous fasciotomy has several potential advantages. The procedure has had lower, less serious, complication rates.…”

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confidence: 99%

Cost Minimisation Using Clinic-Based Treatment for Common Hand Conditions – A Prospective Economic Analysis

Webb

Stothard

2009

annals

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INTRODUCTION The purpose of this study was to compare the cost of treatment of Dupuytren's disease, ganglia and trigger digits in the out-patient department with the operating theatre. PATIENTS AND METHODS All patients seen in a new patient hand clinic with a diagnosis of Dupuytren's disease, trigger digit or ganglion of the wrist or hand requiring treatment were prospectively identified over a 6-month period. The numbers undergoing a procedure in the out-patient clinic or theatre were recorded. Costings of theatre time and out-patient time, as well as national tariff income, were obtained from the hospital management. RESULTS Over the 6-month period, 80, 26, and 52 patients were treated with regard to Dupuytren's disease, ganglia and trigger digits, respectively. Of these, 37, 23, and 44 were treated by an out-patient procedure, and 43, 3 and 8 underwent a formal operation. The total cost of the out-patient procedures was calculated at £1560 over 6 months. To perform these as formal operations would have cost £64,896. The cost savings were, therefore, £63,336, or £126,672 per annum. CONCLUSIONS Out-patient interventions for Dupuytren's disease, ganglia and trigger digits result in significant cost savings over formal surgical treatment.

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confidence: 99%

Cost Minimisation Using Clinic-Based Treatment for Common Hand Conditions – A Prospective Economic Analysis

Webb

Stothard

2009

annals

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“…Contractures were reduced similarly in each group, but the fasciotomy group showed no complications while the fasciectomy group showed 5% (25). A needleclosed fasciotomy often becomes an open fascio-tomy because of finger extension, and the risk of nerve damage increases considerably (19,26). Thus its superiority over OF is rather doubtful.…”

Section: Discussionmentioning

confidence: 95%

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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“…Although greater care is required during release of cords extending into the digit to avoid neurovascular injury, our current surgical technique allows contractures at the interphalangeal joints to be reliably treated. Prior studies on the percutaneous treatment of Dupuytren's contracture have shown significant improvements in TPED [1,2,5,9,18]. Duthie et al described their long-term results of 82 patients treated with percutaneous fasciotomy.…”

Section: Discussionmentioning

confidence: 99%

“…Previous descriptions of the PNA technique report better ability to correct contractures at the metacarpophaleangeal (MP) joint relative to the proximal interphalangeal (PIP) joint. [1,2,9,[16][17][18] Over the last 5 years, the percutaneous technique has become our primary mode of surgical treatment of Dupuytren's contractures. We have incorporated a number of technical modifications that allow extensive cord division in the palm and digits to improve contracture correction, particularly at the PIP joint.…”

Section: Introductionmentioning

confidence: 99%

Modified Percutaneous Needle Aponeurotomy for the Treatment of Dupuytren's Contracture: Early Results and Complications

Herrera

Mitchell

Elzik

et al. 2015

Hand (New York, N,Y.)

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Background The purpose of our study was to identify postoperative results and complications using a percutaneous approach to treat Dupuytren's contracture in a consecutive series of patients. Methods A review of all patients with Dupuytren's contracture treated with percutaneous needle aponeurotomy (NA) from 2008 to 2010 was performed. Patient demographics, digits affected, and disease severity was recorded. Preoperative total passive extension deficit (TPED) was calculated for each affected digit. TPED in the immediate postoperative period and at the time of most recent follow-up was measured. Treatment-related complications and incidence of disease recurrence were identified. Statistical analysis was performed using paired t-test. (Statistical significance p-value <0.05).Results 525 digits in 193 hands were treated with NA. 140 patients were male, average age was 65 years. The average preoperative TPED was 41°and the average immediate postoperative TPED was 1°(98% correction) (P=0.0001). The average TPED at 4.5 month follow up was 11 o (73% correction). Complications included infection in 3 patients and one case each of triggering, delayed flexor tendon rupture, complex regional pain syndrome and persistent numbness. Recurrence was observed in 62 digits. Conclusion Percutaneous needle aponeurotomy is an effective technique in the treatment of Dupuytren's contracture. Near complete correction of contracture was achieved and few complications were observed. Longer follow-up is needed to determine if these short-term results are maintained.

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The long-term results of closed palmar fasciotomy in the management of dupuytren's contracture

Cited by 43 publications

References 2 publications

Cost Minimisation Using Clinic-Based Treatment for Common Hand Conditions – A Prospective Economic Analysis

Cost Minimisation Using Clinic-Based Treatment for Common Hand Conditions – A Prospective Economic Analysis

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

Modified Percutaneous Needle Aponeurotomy for the Treatment of Dupuytren's Contracture: Early Results and Complications

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