Palmar Segmental Aponeurectomy for Dupuytren’s Disease with Metacarpophalangeal flexion Contracture

2001 ◽  
Vol 26 (4) ◽  
pp. 360-361 ◽  
Author(s):  
J. J. CLIBBON ◽  
A. M. LOGAN
Keyword(s):  
Flexion Contracture ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Limited Fasciectomy

Eighty palmar segmental aponeurectomies were performed between 1993 and 1999 for well-localized palmar cords with metacarpophalangeal flexion contracture. A retrospective patient review with a minimum follow-up of 1-year demonstrated a 6% rate of recurrent metacarpophalangeal flexion and two minor complications. Segmental aponeurectomy rather than limited fasciectomy is recommended for this type of disease.

A Comparison of the Direct Outcomes of Percutaneous Needle Fasciotomy and Limited Fasciectomy for Dupuytren’s Disease: A 6-Week Follow-Up Study

2006 ◽  
Vol 31 (5) ◽  
pp. 717-725 ◽  
Author(s):  
Annet L. van Rijssen ◽  
Feike S.J. Gerbrandy ◽  
Hein Ter Linden ◽  
Helen Klip ◽  
Paul M.N. Werker
Keyword(s):  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Follow Up Study ◽  
Limited Fasciectomy

Cleland’s ligaments and Dupuytren’s disease

2013 ◽  
Vol 39 (5) ◽  
pp. 477-481 ◽  
Author(s):  
D. J. Shewring ◽  
U. Rethnam
Keyword(s):  
Histological Analysis ◽  
Residual Disease ◽  
Flexion Contracture ◽  
Joint Contracture ◽  
Dupuytren’S Disease ◽  
Histological Findings ◽  
Dupuytren's Disease ◽  
Pip Joint ◽  
Joint Flexion ◽  
Neurovascular Bundles

The aim of this study was to investigate whether Cleland’s ligaments are affected by Dupuytren’s disease and assess their contribution to the flexion contracture of the proximal interphalangeal (PIP) joint. Twenty patients with Dupuytren’s disease undergoing fasciectomy for a PIP joint contracture > 40° (mean 61°, range 45°–100°) were included. After excision of all other identifiable digital disease, Cleland’s ligaments were assessed. If they appeared to be macroscopically affected by Dupuytren’s disease they were excised, sent for histological analysis, and any further improvement of PIP joint contracture was recorded. There were 14 males and six females with a mean age of 62 (range 40–79) years. Excision of Cleland’s ligaments resulted in a mean further correction of 7° (range 0°–15°). Histological analysis indicated that Cleland’s ligament was clearly involved with Dupuytren’s disease in 12 patients, indicating that Cleland’s ligaments can be affected by Dupuytren’s disease. In the remaining specimens the histological findings were equivocal. As these structures are situated dorsal to the neurovascular bundles, a specific dissection has to be undertaken to identify them. Excision of Cleland’s ligaments at digital fasciectomy further avoids leaving residual disease and may yield a worthwhile further correction of PIP joint flexion contracture.

scholarly journals Serious complications and risk of re-operation after Dupuytren’s disease surgery: a population-based cohort study of 121,488 patients in England

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Osaid Alser ◽  
Richard S. Craig ◽  
Jennifer C. E. Lane ◽  
Albert Prats-Uribe ◽  
Danielle E. Robinson ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Case Series ◽  
Population Based ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Systemic Complications ◽  
Increased Risk ◽  
Risk Patients ◽  
Limited Fasciectomy

Abstract Dupuytren’s disease (DD) is a common fibro-proliferative disorder of the palm. We estimated the risk of serious local and systemic complications and re-operation after DD surgery. We queried England’s Hospital Episode Statistics database and included all adult DD patients who were surgically treated. A longitudinal cohort study and self-controlled case series were conducted. Between 1 April 2007 and 31 March 2017, 121,488 adults underwent 158,119 operations for DD. The cumulative incidence of 90-day serious local complications was low at 1.2% (95% CI 1.1–1.2). However, the amputation rate for re-operation by limited fasciectomy following dermofasciectomy was 8%. 90-day systemic complications were also uncommon at 0.78% (95% CI 0.74–0.83), however operations routinely performed under general or regional anaesthesia carried an increased risk of serious systemic complications such as myocardial infarction. Re-operation was lower than previous reports (33.7% for percutaneous needle fasciotomy, 19.5% for limited fasciectomy, and 18.2% for dermofasciectomy). Overall, DD surgery performed in England was safe; however, re-operation by after dermofasciectomy carries a high risk of amputation. Furthermore, whilst serious systemic complications were unusual, the data suggest that high-risk patients should undergo treatment under local anaesthesia. These data will inform better shared decision-making regarding this common condition.

Recurrence after Surgery for Dupuytren’s Disease: A Randomized Trial of Two Skin Incisions

2005 ◽  
Vol 30 (6) ◽  
pp. 563-566 ◽  
Author(s):  
N. D. CITRON ◽  
V. NUNEZ
Keyword(s):  
Randomized Trial ◽  
Recurrence Rate ◽  
Statistical Difference ◽  
Skin Incision ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Longitudinal Incision

We studied the influence of the type of skin incision on the recurrence rate following fasciectomy for Dupuytren’s disease. Patients were randomized to a longitudinal incision closed with Z-plasties or a modified Bruner incision closed by Y–V plasties. Follow-up was for at least 2 years or until a recurrence was noted. We found no statistical difference in recurrence rate between patients having these two skin incisions and closures.

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