Chen Xu-Hui, Wang Xi-Xun
Department of Orthopaedics, Xin'an International Hospital of Zhejiang, Jiaxing 314000, Zhejiang, China.
Department of Orthopaedics, Xin'an International Hospital of Zhejiang, Jiaxing 314000, Zhejiang, China;
Zhongguo Gu Shang. 2018 Jun 25;31(6):514-517. doi: 10.3969/j.issn.1003-0034.2018.06.006.
To investigate the clinical efficacy of Pi needle percutaneous multi-segmental fasciotomy as a minimally invasive treatment for Dupuytren's contracture.
Sixteen patients(25 fingers: 4 middle fingers, 12 ring fingers, 9 little fingers) were involved in the study, including 11 males and 5 females. There were 2 cases on both hands and 14 cases of single hand disease, including 8 cases of left hand and 6 cases of right hand. The age ranged from 48 to 79 years old, with a mean age of 58.5 years old. The duration of the disease ranged from 1 to 15 years, with a mean time of 5.5 years. There were 12 cases of physical labor, 4 cases of non physical labor, with no family history of palmar fascial contracture. There were 9 cases of tobacco and alcohol addicts, 6 cases with hypertension history, and 3 cases of diabetes mellitus. According to Meyerding classification, 1 case was stage 0, 1 case was stage I, 10 cases were stage II, 4 cases were stage III and 0 case was stage IV. The postoperative function of Dupuytren's contracture patients was evaluated according to Adam efficacy evaluation criteria.
The time of incision healing time ranged from 7 to 14 days, 10 days on average. The 3 fingers incision skin cracked 3 to 4 mm during the loosening process, and 14 days after dressing changed, no skin necrosis and wound infection complication occurred. After treatment, fascia contracture of 24 fingers completely or almost disappeared. Limited extension of metacarpophalangeal joint and interphalangeal joint ranged from 0 to 10 degrees, 22 fingers showed normal function of finger extension, 2 fingers had more than 75% elongation function, and 1 finger recurred. According to the evaluation of Adam evaluable standard of curative effect on the postoperative function of Dupuytrens's contracture: 22 fingers got an excellent result, 2 fingers good and 1 finger recurred. The patients were satisfied with the results of the treatment.
Pi needle percutaneous multi-segmental fasciotomy for the treatment of Dupuytren's contracture is a simple, minimally invasive and effective method.
探讨铍针经皮多节段筋膜切开术作为一种微创治疗杜普伊特伦挛缩症的临床疗效。
16例患者（25指：4例中指、12例环指、9例小指）纳入研究，其中男性11例，女性5例。双手患病2例，单手患病14例，其中左手8例，右手6例。年龄48～79岁，平均年龄58.5岁。病程1～15年，平均5.5年。体力劳动者12例，非体力劳动者4例，无掌腱膜挛缩家族史。有烟酒嗜好者9例，有高血压病史者6例，糖尿病患者3例。根据迈耶丁分类，0期1例，Ⅰ期1例，Ⅱ期10例，Ⅲ期4例，Ⅳ期0例。根据亚当疗效评估标准对杜普伊特伦挛缩症患者术后功能进行评估。
切口愈合时间7～14天，平均10天。3指切口皮肤在松解过程中裂开3～4毫米，换药14天后无皮肤坏死及伤口感染并发症发生。治疗后，24指的筋膜挛缩完全或几乎消失。掌指关节和指间关节伸展受限0～10度，22指手指伸展功能正常，2指伸展功能伸长超过75%，1指复发。根据亚当对杜普伊特伦挛缩症术后功能疗效评估标准评估：优22指，良2指，复发1指。患者对治疗结果满意。
铍针经皮多节段筋膜切开术治疗杜普伊特伦挛缩症是一种简单、微创且有效的方法。
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