[掌腱膜挛缩症的手术治疗：近端指间关节关节松解术]
[Operative treatment of Dupuytren's contracture : Arthrolysis of the proximal interphalangeal finger joint].
作者信息
Hohendorff B, Franke J, Spies C K, Unglaub F, Müller L P, Ries C
机构信息
Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Bremervörder Straße 111, 21682, Stade, Deutschland.
Klinik für Unfallchirurgie und Orthopädie, Elbe Klinikum Stade, Stade, Deutschland.
出版信息
Orthopade. 2017 Apr;46(4):328-335. doi: 10.1007/s00132-017-3387-5.
BACKGROUND
In the operative treatment of Dupuytren's disease, in certain cases proximal interphalangeal joint flexion contracture remains after fasciectomy due to shrinkage, shortening, and/or adhesion of the periarticular structures.
OBJECTIVES
How can a residual flexion contracture of the proximal interphalangeal joint after partial fasciectomy in Dupuytren's disease be treated surgically and what follow-up results can be expected?
METHODS
Description of anatomy, indication, surgical technique of arthrolysis of the proximal interphalangeal joint, postoperative treatment, and critical analysis of the results reported in the literature.
RESULTS
Arthrolysis of the proximal interphalangeal joint is performed in up to six consecutive steps. An improvement of only about 50% compared to preoperative flexion contracture can be expected.
CONCLUSIONS
Despite alleged unsatisfactory results arthrolysis of the proximal interphalangeal joint can be recommended in surgery of Dupuytren's disease. In certain cases, patient cooperation during lengthy postoperative treatment is necessary.
背景
在杜普伊特伦挛缩症的手术治疗中，在某些情况下，由于关节周围结构的收缩、缩短和/或粘连，筋膜切除术后近端指间关节仍会出现屈曲挛缩。
目的
在杜普伊特伦挛缩症患者行部分筋膜切除术后，近端指间关节残留的屈曲挛缩如何进行手术治疗，预期的随访结果如何？
方法
描述近端指间关节松解术的解剖结构、适应证、手术技术、术后治疗，并对文献报道的结果进行批判性分析。
结果
近端指间关节松解术最多分六个连续步骤进行。与术前屈曲挛缩相比，预计仅能改善约50%。
结论
尽管近端指间关节松解术的效果据称不尽人意，但在杜普伊特伦挛缩症手术中仍可推荐使用。在某些情况下，术后长期治疗中患者的配合是必要的。
Zotero 插件