Hasselbacher K, Bleuel S, Landsleitner Dagger B
Klinik für Handchirurgie, Abteilung II, Rhön-Klinikum Bad Neustadt/Saale.
Handchir Mikrochir Plast Chir. 2002 Nov;34(6):355-62. doi: 10.1055/s-2002-37473.
Palmar arthrolysis of the proximal interphalangeal joint is seldom carried out as an isolated treatment of contractures. The operation is usually performed in connection with treatment for a primary illness. Although intra-operative extension of the interphalangeal joint is normally completely achieved, the postoperative results show deficiencies in the extension. METHODS AND CLINICAL MATERIAL: The long-term results of 110 arthrolyses of the proximal interphalangeal joint of 102 patients are presented. The operations were performed on average 4.6 years ago. The analysis was made with standard questionnaires and self-made drawings along the side of the patients' maximally extended finger.
"Successful operations" where performed on 76% of all released joints. The angle of the contracture was reduced by at least 10 degrees in these joints. The long-term results were compared in conjunction with results of injuries or operations of other illnesses: M. Dupuytren (primary), relapses of M. Dupuytren, lesions of the flexor tendons, camptodactyly, results of injuries due to the consequences of operations or other illnesses. The results in the group of lesions of the flexor tendons were on the whole unsuccessful.
Even though thorough postoperative hand therapy(physiotherapy and use of splints) and above-average co-operation of the patients are prerequisites for a successful arthrolysis, it can be seen that the elimination of the underlying illness is of primary importance.
近端指间关节掌侧关节松解术很少作为挛缩的单一治疗方法进行。该手术通常与原发性疾病的治疗同时进行。尽管术中指间关节的伸展通常能完全实现，但术后结果显示伸展存在不足。
介绍了102例患者110次近端指间关节松解术的长期结果。手术平均在4.6年前进行。通过标准问卷和患者最大伸展手指一侧的自制绘图进行分析。
76%的所有松解关节进行了“成功手术”。这些关节的挛缩角度至少减小了10度。将长期结果与其他疾病的损伤或手术结果进行了比较：杜普伊特伦病（原发性）、杜普伊特伦病复发、屈肌腱损伤、先天性屈曲指、手术或其他疾病后果导致的损伤结果。屈肌腱损伤组的结果总体上不成功。
尽管术后彻底的手部治疗（物理治疗和使用夹板）以及患者高于平均水平的配合是关节松解术成功的先决条件，但可以看出消除潜在疾病至关重要。
