Gelman Scott E, Schlenker Robert, Jacoby Sidney M, Shin Eon K, Culp Randall W
Department of Orthopaedic Surgery, Division of Hand Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Tech Hand Up Extrem Surg. 2012 Dec;16(4):184-6. doi: 10.1097/BTH.0b013e31826246f2.
Treatment options for the Dupuytren contractures vary from percutaneous needle aponeurotomy, open fasciotomy or fasciectomy, dermofasciectomy, and more recently, injectable collagenase. Although utilization of injectable collagenase avoids a formal surgical procedure, not all patients are eligible and some patients do not feel comfortable with an enzyme injection or the associated risks, which may include hematoma, wound dehiscence, or tendon rupture. This study describes the technique and early results of partial fasciectomy through a mini-incision approach as an additional treatment option for Dupuytren contractures. We found that this procedure results in contracture correction with a low rate of complications and thus provides the surgeon with an alternative treatment option to offer patients.
杜普伊特伦挛缩的治疗选择多种多样,包括经皮针状腱膜切开术、开放性筋膜切开术或筋膜切除术、皮肤筋膜切除术,以及最近出现的注射用胶原酶。尽管使用注射用胶原酶可避免正规手术,但并非所有患者都适用,而且一些患者对酶注射或相关风险(可能包括血肿、伤口裂开或肌腱断裂)感到不适。本研究描述了通过小切口入路进行部分筋膜切除术的技术及早期结果,作为杜普伊特伦挛缩的一种额外治疗选择。我们发现,该手术可矫正挛缩,并发症发生率低,从而为外科医生提供了一种可供患者选择的替代治疗方案。