From the Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine; Department of Plastic Surgery, Medical College of Wisconsin; and Division of Plastic Surgery, Ann & Robert H. Lurie Children's Hospital.
Plast Reconstr Surg. 2022 Jul 1;150(1):127e-135e. doi: 10.1097/PRS.0000000000009181. Epub 2022 May 10.
The American Board of Plastic Surgery collects data on 20 common plastic surgery operations as part of the Continuous Certification process. The goal of this study was to describe clinical trends in Dupuytren contracture repair since 2008 as they relate to evidence-based medicine articles published in this timeframe.
Cumulative tracer data for Dupuytren contracture were reviewed for the period from February of 2008 to March of 2020 and compared with evidence-based medicine articles published in Plastic and Reconstructive Surgery . Topics were categorized as (1) pearls, addressed in both the tracer data and evidence-based medicine articles, (2) topics only addressed in tracer data, and (3) topics only addressed in evidence-based medicine articles.
As of March of 2020, 230 cases of Dupuytren contracture had been entered. The median age at time of surgery was 65 years (range, 38 to 91 years). Practice patterns from 2008 through 2014 were compared with those between 2015 and 2020. The most common surgical technique was limited fasciectomy (62 percent of cases). Differences in practice between these time periods included decrease in the use of radical fasciectomy (34 percent versus 16 percent, p = 0.002), increase in percutaneous cordotomy (0 percent versus 13 percent), and increase in the use of collagenase injections (0 percent versus 9 percent, p = 0.001). Use of Bier blocks increased (1 percent versus 7 percent), and tourniquet use decreased (97 percent versus 80 percent). Significant changes were also noted in postoperative management.
By examining American Board of Plastic Surgery tracer data, the authors have described national trends in presentation and surgical techniques for Dupuytren contracture repair over a 14-year period.
美国整形外科学会（American Board of Plastic Surgery）在持续认证过程中收集了 20 种常见整形手术的数据。本研究的目的是描述自 2008 年以来，掌腱膜挛缩修复术的临床趋势，以及它们与该时间段发表的循证医学文章之间的关系。
回顾 2008 年 2 月至 2020 年 3 月期间掌腱膜挛缩的累积示踪数据，并与《整形与重建外科》杂志上发表的循证医学文章进行比较。将主题分为（1）示踪数据和循证医学文章均涉及的要点，（2）仅在示踪数据中涉及的主题，和（3）仅在循证医学文章中涉及的主题。
截至 2020 年 3 月，已有 230 例掌腱膜挛缩病例输入系统。手术时的中位年龄为 65 岁（范围 38 至 91 岁）。比较 2008 年至 2014 年期间和 2015 年至 2020 年期间的手术模式。最常见的手术技术是局限性筋膜切开术（62%的病例）。这两个时间段之间手术实践的差异包括根治性筋膜切开术的使用率降低（34%对 16%，p=0.002）、经皮腱索切开术的使用率增加（0%对 13%）和胶原酶注射的使用率增加（0%对 9%，p=0.001）。Bier 块的使用率增加（1%对 7%），止血带的使用率降低（97%对 80%）。术后管理也发生了显著变化。
通过检查美国整形外科学会示踪数据，作者描述了 14 年来全国掌腱膜挛缩修复术的表现和手术技术趋势。
