Högemann A, Wolfhard U, Kendoff D, Board T N, Olivier L C
Department of Traumatology, Hand and Reconstructive Surgery, St.Josefs-Hospital Cloppenburg, Krankenhausstr.13, 49661 Cloppenburg, Germany.
Arch Orthop Trauma Surg. 2009 Feb;129(2):195-201. doi: 10.1007/s00402-008-0657-z. Epub 2008 May 31.
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.
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)].
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.
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.
许多外科技术被提倡用于治疗杜普伊特伦挛缩症。部分筋膜切除术常被用于治疗杜普伊特伦病的整个谱系。
我们回顾了对61例患者(10名女性和51名男性,男女比例为5.1:1,平均年龄63.0岁,范围42 - 79岁,平均随访3.45年,范围1.03 - 6.39年)进行全腱膜切除术的有效性。
13.8%的患者出现术后并发症,包括血肿、血清肿或坏死。10.8%的患者挛缩复发,4.6%的手术患者出现神经损伤。6.2%的患者出现神经刺激。平均DASH评分为3.85(范围0 - 52.5)。家族易感性是杜普伊特伦病的一个重要危险因素,44.3%的患者有阳性家族史。
我们认为全腱膜切除术是部分筋膜切除术的一种有前景的替代方法,复发风险低,神经损伤风险略有增加。