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手指缩短术治疗杜普伊特伦挛缩症所致小指严重近端指间关节屈曲挛缩:两例报告

Finger shortening for Dupuytren's disease-induced severe PIP joint flexion contracture of the little finger: A report of two cases.

作者信息

Ito Yoko, Naito Kiyohito, Nagura Nana, Sugiyama Yoichi, Obata Hiroyuki, Kaneko Ayaka, Goto Kenji, Kaneko Kazuo, Ishijima Muneaki

机构信息

Department of Orthopaedics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421 Tokyo, Japan.

出版信息

SICOT J. 2021;7:11. doi: 10.1051/sicotj/2021005. Epub 2021 Mar 8.

Abstract

When severe proximal interphalangeal (PIP) joint flexion contracture is induced in the little finger by Dupuytren's disease, it interferes with activities of daily living. To extend the little finger, open fasciectomy is selected as a general treatment method. However, postoperative complications have been frequently reported. To solve these problems, finger shortening was undertaken. In this study, we treated two cases of Dupuytren's disease manifesting severe PIP joint flexion contracture of the little finger with finger shortening by proximodistal interphalangeal (PDIP) fusion in which the middle phalanx is resected and the residual distal and proximal phalanges are fused. For flexion contracture of the MP joint, a percutaneous aponeurotomy using an 18G needle was performed to obtain the extended position of the MP joint. Favorable outcomes with high patient satisfaction, including esthetic aspects of retaining the finger with the nail without complication, were achieved. We report this challenging treatment and its discussion.

摘要

当小指因杜普伊特伦挛缩病出现严重的近端指间关节(PIP)屈曲挛缩时,会干扰日常生活活动。为了伸直小指,开放性筋膜切除术是常用的治疗方法。然而,术后并发症屡有报道。为了解决这些问题,进行了手指缩短术。在本研究中,我们对两例杜普伊特伦挛缩病患者进行了治疗,这些患者表现为小指严重的近端指间关节屈曲挛缩,采用近远侧指间关节(PDIP)融合术进行手指缩短,即切除中节指骨,将残留的远节和近节指骨融合。对于掌指关节(MP)的屈曲挛缩,使用18G针进行经皮腱膜切开术以获得掌指关节的伸直位。取得了良好的效果,患者满意度高,包括保留有指甲的手指且无并发症的美学效果。我们报告这种具有挑战性的治疗方法及其讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fb9/7938730/1877ab9b4ef7/sicotj-7-11-fig1.jpg

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