Crean S M, Gerber R A, Le Graverand M P Hellio, Boyd D M, Cappelleri J C
United BioSource Corporation, Lexington, MA 02420, USA.
J Hand Surg Eur Vol. 2011 Jun;36(5):396-407. doi: 10.1177/1753193410397971. Epub 2011 Mar 7.
A structured review of published papers was done to assess the efficacy and safety of fasciectomy and fasciotomy in European patients with Dupuytren's contracture. The outcomes varied across 48 studies. For fasciectomy, outcomes and results were as follows: the proportions of patients with a 100% correction in contracture angle ranged from 61 to 97%, the mean improvement in contracture angle ranged from 58 to 79%, and cases judged excellent/good ranged from 63 to 90%. Fasciotomy had similar outcomes, with a mean improvement in contracture angle ranging from 46 to 88%. Immediate failures upon recovery were reported for both procedures. The average recurrence rates were 39% after a fasciectomy and 62% after a fasciotomy at a median time of about 4 years. Overall, about 20% of fasciectomy and fasciotomy patients experienced an adverse event. In summary, postoperative outcomes were successful, but surgical complications were common and recurrence of a contracture was likely within a few years.
对已发表论文进行了结构化综述，以评估筋膜切除术和筋膜切开术在欧洲杜普伊特伦挛缩症患者中的疗效和安全性。48项研究的结果各不相同。对于筋膜切除术，结果如下：挛缩角矫正100%的患者比例在61%至97%之间，挛缩角的平均改善幅度在58%至79%之间，评定为优秀/良好的病例在63%至90%之间。筋膜切开术有类似结果，挛缩角的平均改善幅度在46%至88%之间。两种手术均报告了恢复时的即刻失败情况。筋膜切除术后平均复发率在约4年的中位时间为39%，筋膜切开术后为62%。总体而言，约20%的筋膜切除术和筋膜切开术患者经历了不良事件。总之，术后结果是成功的，但手术并发症很常见，挛缩可能在几年内复发。
