Fernando A Herrera1, Scott Mitchell2, Mark Elzik2, Jason Roostaeian3, Prosper Benhaim4. 1. Division of Plastic and Reconstructive Surgery, University of California Los Angeles, Los Angeles, CA 90095 USA ; Department of Orthopaedic Surgery, University of California Los Angeles, Santa Monica, CA 90404 USA ; Division of Plastic and Reconstructive Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, South Carolina 29425 USA. 2. Department of Orthopaedic Surgery, University of California Los Angeles, Santa Monica, CA 90404 USA. 3. Division of Plastic and Reconstructive Surgery, University of California Los Angeles, Los Angeles, CA 90095 USA. 4. Division of Plastic and Reconstructive Surgery, University of California Los Angeles, Los Angeles, CA 90095 USA ; Department of Orthopaedic Surgery, University of California Los Angeles, Santa Monica, CA 90404 USA.
Abstract
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. Pre-operative 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.
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. Pre-operative 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.
Authors: Robert B Shaw; Alphonsus K S Chong; Andrew Zhang; Vincent R Hentz; James Chang Journal: Plast Reconstr Surg Date: 2007-09 Impact factor: 4.730
Authors: Annet L van Rijssen; Feike S J Gerbrandy; Hein Ter Linden; Helen Klip; Paul M N Werker Journal: J Hand Surg Am Date: 2006 May-Jun Impact factor: 2.230