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. 2012 Dec;7(4):364-9.
doi: 10.1007/s11552-012-9461-x.

Minimally invasive partial fasciectomy for Dupuytren's contractures

Scott Gelman  1 , Robert Schlenker, Abdo Bachoura, Sidney M Jacoby, Jeffrey Lipman, Eon K Shin, Randall W Culp
Affiliations

Minimally invasive partial fasciectomy for Dupuytren's contractures

Scott Gelman et al. Hand (N Y). 2012 Dec.

Abstract

Background: Numerous options exist for the treatment of Dupuytren's contracture. This study describes the technique and early results of partial fasciectomy through a mini-incision approach as an additional treatment option for Dupuytren's disease.

Methods: This procedure involves the excision of diseased Dupuytren's tissue with the use of multiple 1 cm transverse incisions. Patient demographics, digit involvement, the number of incisions required to release each digit, and complications were recorded for all patients. Range of motion data was obtained from a subgroup of patients that had at least 6 months of follow-up. A paired t test was used to compare preoperative and postoperative contracture.

Results: Sixty-seven patients underwent 75 procedures that involved 119 digits. The mean patient age at the time of surgery was 63 years (range, 33-95 years). A total of 32 digits (47 joints) were available for range of motion analysis. After a mean of 2.2 years following surgery, metacarpophalangeal joint contractures maintained correction (34° preoperatively, 19° postoperatively, p = 0.008). After a mean postoperative duration of 2.0 years, proximal interphalangeal joint contractures trended worse than preoperative levels (39° preoperatively, 45° postoperatively, p = 0.319). There was one major complication, which consisted of a nerve laceration that was identified and repaired intraoperatively.

Conclusions: Partial fasciectomy through the described mini-incision approach provides an additional surgical option for patients who desire a less invasive surgical procedure than traditional fascietomy. Although this procedure is safe and effective at achieving immediate cord release, maintenance of correction for proximal interphalangeal joint contractures remains problematic.

Keywords: Dupuytren’s contracture; Fasciectomy; Minimally invasive.

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Figures

Fig. 1
Fig. 1
Incision locations are marked preoperatively over the cord. a Frontal plane; b oblique plane
Fig. 2
Fig. 2
Intraoperative photograph depicting the excision of part of a Dupuytren’s cord through a 1-cm transverse incision
Fig. 3
Fig. 3
Intraoperative photograph after multiple incisions and release of all cords to achieve maximum extension
See this image and copyright information in PMC

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References

    1. Anwar MU, Ghazal SK, Boome RS. Results of surgical treatment of Dupuytren’s disease in women: a review of 109 consecutive patients. J Hand Surg Am. 2007;32:1423–1428. doi: 10.1016/j.jhsa.2007.06.015. - DOI - PubMed
    1. Badalamente MA, Hurst LC. Enzyme injection as nonsurgical treatment of Dupuytren’s disease. J Hand Surg Am. 2000;25:629–636. doi: 10.1053/jhsu.2000.6918. - DOI - PubMed
    1. Badalamente MA, Hurst LC. Efficacy and safety of injectable mixed collagenase subtypes in the treatment of Dupuytren’s contracture. J Hand Surg Am. 2007;32:767–774. doi: 10.1016/j.jhsa.2007.04.002. - DOI - PubMed
    1. Badalamente MA, Hurst LC, Hentz VR. Collagen as a clinical target: nonoperative treatment of Dupuytren’s disease. J Hand Surg Am. 2002;27:788–798. doi: 10.1053/jhsu.2002.35299. - DOI - PubMed
    1. Brandt KE. An evidence-based approach to Dupuytren’s contracture. Plast Reconstr Surg. 2010;126:2210–2215. doi: 10.1097/PRS.0b013e3181f83129. - DOI - PubMed

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