Severe Contracture of the Proximal Interphalangeal Joint in Dupuytren’s Disease: Does Capsuloligamentous Release Improve Outcome?

2004 ◽  
Vol 29 (3) ◽  
pp. 238-241 ◽  
Author(s):  
K. BEYERMANN ◽  
K. J. PROMMERSBERGER ◽  
C. JACOBS ◽  
U. B. LANZ
Keyword(s):  
Prospective Study ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Contracture ◽  
Dupuytren’S Disease ◽  
Postoperative Rehabilitation ◽  
Dupuytren's Disease ◽  
Improve Outcome ◽  
Capsuloligamentous Release

This prospective study assessed whether patients with severe proximal interphalangeal joint contracture (≥60°) due to Dupuytren’s disease which persisted after fasciectomy alone benefited from an additional capsuloligamentous release. Forty-three patients with 43 severely contracted proximal interphalangeal joints underwent operative correction followed by a standardized postoperative rehabilitation programme. All were followed for 6 months. In 11 patients correction of the proximal interphalangeal joint to 20° could not be achieved by fasciectomy alone, and an additional capsuloligamentous release was performed which effectively corrected all their residual flexion contractures. There were no statistically significant differences between the capsulotomy and the non-capsulotomy group with respect to the residual proximal interphalangeal joint contracture at the end of surgery, or at their last follow-up examination.

SEVERE CONTRACTURES OF THE PROXIMAL INTERPHALANGEAL JOINT IN DUPUYTREN'S DISEASE: VALUE OF CAPSULOLIGAMENTOUS RELEASE

Hand Surgery ◽  
1999 ◽  
Vol 04 (01) ◽  
pp. 57-61 ◽  
Author(s):  
Kirsten Beyermann ◽  
Corinna Jacobs ◽  
Ulrich Lanz
Keyword(s):  
Retrospective Review ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Flexion Contractures ◽  
Significant Difference ◽  
Capsuloligamentous Release

A retrospective review of severe flexion contractures (60° or more), involving 51 proximal interphalangeal joints in 40 patients with Dupuytren's disease, was performed. Thirty-two joints underwent aponeurectomy alone, 19 joints additional capsuloligamentous release. Mean follow-up was 12 months. No statistically significant difference was seen in the percentage of contracture correction in the capsulotomy group compared with the noncapsulotomy group.

The Proximal Interphalangeal Joint in Dupuytren’s Disease

1985 ◽  
Vol 10 (3) ◽  
pp. 358-364
Author(s):  
M. A. TONKIN ◽  
F. D. BURKE ◽  
J. P. W. VARIAN
Keyword(s):  
Surgical Approach ◽  
Proximal Phalanx ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Contracture ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Average Percentage ◽  
Percentage Improvement

In one hundred patients with Dupuytren’s disease, one hundred and fifty-four operations were performed. The average pre-operative proximal interphalangeal joint contracture was 42° and the average percentage improvement in proximal interphalangeal joint extension at post­operative review was 41%. Fourteen amputations were performed (9.1%). The primary deformity is caused by disease involvement of the palmar fascial structures. Secondary changes may prevent correction of the deformity despite excision of the contracted fascia. The anatomy of the joint is reviewed together with the primary and secondary mechanisms of joint contracture in Dupuytren's disease. Arthrodesis, osteotomy of the proximal phalanx and joint replacement are considered as alternatives to amputation when a systematic surgical approach fails to correct the flexion contracture.

Nonoperative treatment of PIPJ flexion contractures associated with Dupuytren’s disease

2011 ◽  
Vol 37 (8) ◽  
pp. 722-727 ◽  
Author(s):  
J. Larocerie-Salgado ◽  
J. Davidson
Keyword(s):  
Soft Tissue ◽  
Nonoperative Treatment ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Patient Dissatisfaction ◽  
Flexion Contractures ◽  
Alternative Treatment Option ◽  
Soft Tissue Mobilization

Post-surgical outcomes in patients with Dupuytren’s disease causing flexion contractures of the proximal interphalangeal joint can be inconsistent and are often associated with protracted rehabilitation, reduced flexion, recurrence of the contracture, and patient dissatisfaction. An alternative treatment option, comprised of splinting and soft tissue mobilization techniques, was introduced to stabilize early contractures of the proximal interphalangeal joint in the hopes of delaying or obviating surgery. Over the course of approximately 12.6 months (±7.8), thirteen patients were followed at the hand clinic at Hotel Dieu Hospital in Kingston. One patient was unable to complete the course of therapy. Of the remaining patients, analysis showed significant improvement in active proximal interphalangeal joint extension of approximately 14.6° (SD: ±5.1°; range: 5–25°) over the course of the treatment ( p < .05). Nighttime static extension splinting and soft tissue mobilization techniques appear to delay and possibly prevent the need for surgery in individuals with flexion contractures of the proximal interphalangeal joint due to Dupuytren’s disease.

Treatment of fracture subluxations of the proximal interphalangeal joint using a ligamentotaxis device: a multidisciplinary approach

2015 ◽  
Vol 40 (8) ◽  
pp. 825-831 ◽  
Author(s):  
R. J. MacFarlane ◽  
S. Gillespie ◽  
F. Cashin ◽  
A. Mahmood ◽  
G. Cheung ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Outcome Variable ◽  
Postoperative Rehabilitation ◽  
Joint Range Of Motion ◽  
The Mean ◽  
Joint Range ◽  
Mean Time

Complex fracture subluxations of the proximal interphalangeal joint are often difficult to treat and their outcome variable. A number of methods for treatment of these injuries have been described. We have used a ligamentotaxis device ( Ligamentotaxor, Arex, Palaiseau Cedex, France) since 2008. We performed 28 operations in 28 patients with complex proximal interphalangeal joint injuries over a 3-year period. Patients followed a standardized postoperative rehabilitation regime, including fixator adjustment as necessary. The mean age was 33 years (range 18–67). The mean time to surgery was 7 days. At final follow-up (mean 22 months, range 6–52) the mean proximal interphalangeal joint range of motion was 85° (range 60°–110°). The mean QuickDASH functional outcome score was 4.8 (range 0–36.4). Our results compare favourably with other devices reported in the literature.

Predicting the Outcome of Surgery for the Proximal Interphalangeal Joint in Dupuytren’s Disease

2007 ◽  
Vol 32 (2) ◽  
pp. 240-245 ◽  
Author(s):  
Alok Misra ◽  
Abhilash Jain ◽  
Reza Ghazanfar ◽  
Terrencia Johnston ◽  
Jagdeep Nanchahal
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Outcome Of Surgery

Capsular Tissues of the Proximal Interphalangeal Joint: Normal Composition and Effects of Dupuytren’s Disease and Rheumatoid Arthritis

1993 ◽  
Vol 18 (3) ◽  
pp. 371-376 ◽  
Author(s):  
M. BENJAMIN ◽  
J. R. RALPHS ◽  
M. SHIBU ◽  
M. IRWIN
Keyword(s):  
Rheumatoid Arthritis ◽  
Type Ii Collagen ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Volar Plate ◽  
Dupuytren's Disease ◽  
Extracellular Matrix Components ◽  
Central Slip ◽  
Normal Composition

Three fibrocartilages associated with the proximal interphalangeal joint are described—at the attachment of the central slip to bone, within the slip where it passes over the joint, and the volar plate. Material was obtained at surgery following trauma, Dupuytren’s disease and rheumatoid arthritis. The fibrocartilages were structurally distinct and immunolabelled differently with monoclonal antibodies to extracellular matrix components. All fibrocartilages from normal and Dupuytren’s fingers contained chondroitin and keratan sulphate. Type II collagen was present in all attachment zones, although there was little in rheumatoid fingers. It was also present in the dorsal hood of some normal fingers, but not in pathological specimens or the volar plate. The results show that the fibrocartilages are dynamic tissues whose composition varies according to function and use, and changes in disease.

Sign in / Sign up

Export Citation Format

Share Document