A Högemann1, U Wolfhard, D Kendoff, T N Board, L C Olivier. 1. Department of Traumatology, Hand and Reconstructive Surgery, St.Josefs-Hospital Cloppenburg, Krankenhausstr.13, 49661 Cloppenburg, Germany.
Abstract
INTRODUCTION: Many surgical techniques have been advocated to treat Dupuytren's contracture. Partial fasciectomy is often performed to treat the whole spectrum of Dupuytren's disease. METHOD: We have reviewed the effectiveness of total aponeurectomy performed on 61 patients [10 women and 51 men (male:female ratio 5.1:1) with a mean age of 63.0 (range 42-79 years) and a mean follow-up of 3.45 years (range 1.03-6.39 years)]. RESULTS: Post-operative complications including haematoma, seroma or necrosis were found in 13.8% of the patients. Recurrence of contracture occurred in 10.8% of the patients and 4.6% of the operated patients presented with a nerve lesion. Nerve irritation occurred in 6.2% of the patients. The mean DASH-score was 3.85 (range 0-52.5). Family pre-disposition was an important risk factor for Dupuytren's disease with 44.3% of patients having a positive family history. CONCLUSION: We suggest that total aponeurectomy is a promising alternative to partial fasciectomy with low risk for a recurrence and slightly increased risk for a nerve lesion.
INTRODUCTION: Many surgical techniques have been advocated to treat Dupuytren's contracture. Partial fasciectomy is often performed to treat the whole spectrum of Dupuytren's disease. METHOD: We have reviewed the effectiveness of total aponeurectomy performed on 61 patients [10 women and 51 men (male:female ratio 5.1:1) with a mean age of 63.0 (range 42-79 years) and a mean follow-up of 3.45 years (range 1.03-6.39 years)]. RESULTS: Post-operative complications including haematoma, seroma or necrosis were found in 13.8% of the patients. Recurrence of contracture occurred in 10.8% of the patients and 4.6% of the operated patients presented with a nerve lesion. Nerve irritation occurred in 6.2% of the patients. The mean DASH-score was 3.85 (range 0-52.5). Family pre-disposition was an important risk factor for Dupuytren's disease with 44.3% of patients having a positive family history. CONCLUSION: We suggest that total aponeurectomy is a promising alternative to partial fasciectomy with low risk for a recurrence and slightly increased risk for a nerve lesion.
Authors: Chris Bainbridge; Robert A Gerber; Piotr P Szczypa; Ted Smith; Harvey Kushner; Brian Cohen; Marie-Pierre Hellio Le Graverand-Gastineau Journal: J Plast Surg Hand Surg Date: 2012-06-07