B Hohendorff1, J Franke2, C K Spies3, F Unglaub3, L P Müller4, C Ries4. 1. Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Bremervörder Straße 111, 21682, Stade, Deutschland. bernd.hohendorff@hotmail.com. 2. Klinik für Unfallchirurgie und Orthopädie, Elbe Klinikum Stade, Stade, Deutschland. 3. Handchirurgie, Vulpius Klinik, Bad Rappenau, Deutschland. 4. Unfall-, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum zu Köln, Köln, Deutschland.
Abstract
BACKGROUND: In the operative treatment of Dupuytren's disease, in certain cases proximal interphalangeal joint flexion contracture remains after fasciectomy due to shrinkage, shortening, and/or adhesion of the periarticular structures. OBJECTIVES: How can a residual flexion contracture of the proximal interphalangeal joint after partial fasciectomy in Dupuytren's disease be treated surgically and what follow-up results can be expected? METHODS: Description of anatomy, indication, surgical technique of arthrolysis of the proximal interphalangeal joint, postoperative treatment, and critical analysis of the results reported in the literature. RESULTS: Arthrolysis of the proximal interphalangeal joint is performed in up to six consecutive steps. An improvement of only about 50% compared to preoperative flexion contracture can be expected. CONCLUSIONS: Despite alleged unsatisfactory results arthrolysis of the proximal interphalangeal joint can be recommended in surgery of Dupuytren's disease. In certain cases, patient cooperation during lengthy postoperative treatment is necessary.
BACKGROUND: In the operative treatment of Dupuytren's disease, in certain cases proximal interphalangeal joint flexion contracture remains after fasciectomy due to shrinkage, shortening, and/or adhesion of the periarticular structures. OBJECTIVES: How can a residual flexion contracture of the proximal interphalangeal joint after partial fasciectomy in Dupuytren's disease be treated surgically and what follow-up results can be expected? METHODS: Description of anatomy, indication, surgical technique of arthrolysis of the proximal interphalangeal joint, postoperative treatment, and critical analysis of the results reported in the literature. RESULTS: Arthrolysis of the proximal interphalangeal joint is performed in up to six consecutive steps. An improvement of only about 50% compared to preoperative flexion contracture can be expected. CONCLUSIONS: Despite alleged unsatisfactory results arthrolysis of the proximal interphalangeal joint can be recommended in surgery of Dupuytren's disease. In certain cases, patient cooperation during lengthy postoperative treatment is necessary.