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采用多个横向切口手术松解掌腱膜挛缩症

The Surgical Release of Dupuytren's Contracture Using Multiple Transverse Incisions.

作者信息

Lee Hyunjic, Eo Surak, Cho Sanghun, Jones Neil F

机构信息

Department of Plastic and Reconstructive Surgery, Dongguk University Ilsan Hospital, Dongguk Graduate School of Medicine, Goyang, Korea.

出版信息

Arch Plast Surg. 2012 Jul;39(4):426-30. doi: 10.5999/aps.2012.39.4.426. Epub 2012 Jul 13.

Abstract

Dupuytren's contracture is a condition commonly encountered by hand surgeons, although it is rare in the Asian population. Various surgical procedures for Dupuytren's contracture have been reported, and the outcomes vary according to the treatment modalities. We report the treatment results of segmental fasciectomies with multiple transverse incisions for patients with Dupuytren's contracture. The cases of seven patients who underwent multiple segmental fasciectomies with multiple transverse incisions for Dupuytren's contracture from 2006 to 2011 were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites were performed initially, and additional incisions to the metacarpophalangeal (MCP) joints, and the proximal interphalangeal (PIP) joints were performed if necessary. Segmental fasciectomies by removing the fibromatous nodules or cords between the incision lines were performed and the wound margins were approximated. The mean range of motion of the involved MCP joints and PIP joints was fully recovered. During the follow-up periods, there was no evidence of recurrence or progression of disease. Multiple transverse incisions for Dupuytren's contracture are technically challenging, and require a high skill level of hand surgeons. However, we achieved excellent correction of contractures with no associated complications. Therefore, segmental fasciectomies with multiple transverse incisions can be a good treatment option for Dupuytren's contracture.

摘要

掌腱膜挛缩症是手外科医生常见的病症,尽管在亚洲人群中较为罕见。已有多种针对掌腱膜挛缩症的手术方法被报道,其结果因治疗方式而异。我们报告了采用多个横向切口的节段性筋膜切除术治疗掌腱膜挛缩症的结果。回顾性分析了2006年至2011年期间接受多个横向切口的节段性筋膜切除术治疗掌腱膜挛缩症的7例患者的病例。首先在严重挛缩部位做多个横向切口,必要时在掌指关节(MCP)和近端指间关节(PIP)处做额外切口。通过切除切口线之间的纤维瘤性结节或条索进行节段性筋膜切除术,并将伤口边缘对合。受累MCP关节和PIP关节的平均活动范围完全恢复。在随访期间,没有疾病复发或进展的迹象。掌腱膜挛缩症的多个横向切口在技术上具有挑战性,需要手外科医生具备较高的技术水平。然而,我们实现了挛缩的良好矫正且无相关并发症。因此,多个横向切口的节段性筋膜切除术可以是掌腱膜挛缩症的一种良好治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9fe/3408292/16eb6ce5a358/aps-39-426-g001.jpg

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