Department of Plastic Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
Department of Orthopedic Surgery-Hand Unit, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
Hand Surg Rehabil. 2023 Sep;42(4):273-283. doi: 10.1016/j.hansur.2023.06.002. Epub 2023 Jun 17.
Dupuytren's disease is a progressive hand disorder characterized by the formation of pathologic nodules and cords in the palm, often leading to progressive flexion contractures. Hand surgery is currently the only efficient treatment to restore hand function, however, reported recurrence rates vary widely. Currently, it remains unclear which type of fasciectomy is associated with the lowest recurrence rate. Therefore, a systematic review was conducted to compare recurrence rates after limited fasciectomy, open palm technique, or dermofasciectomy with a full-thickness skin graft. 79 studies were included, and results suggest that a dermofasciectomy with a full-thickness skin graft is associated with a lower recurrence rate. However, most studies were case series in which a wide range of definitions of recurrence was used. Moreover, all studies had a high risk of bias. Therefore, additional comparative clinical trials are recommended that use an unambiguous definition of recurrence. LEVEL OF EVIDENCE III: .
掌腱膜挛缩症是一种手部进行性疾病,其特征为手掌内形成病理性结节和索带,常导致进行性掌指关节屈曲挛缩。手部手术是目前恢复手部功能的唯一有效治疗方法,但报道的复发率差异很大。目前,尚不清楚哪种筋膜切除术与最低复发率相关。因此,进行了一项系统评价,以比较局限性筋膜切除术、开放式手掌技术或带全厚皮片的皮下松解术的复发率。共纳入 79 项研究,结果表明带全厚皮片的皮下松解术与较低的复发率相关。然而,大多数研究为病例系列研究,其中使用了广泛的复发定义。此外,所有研究均存在较高的偏倚风险。因此,建议开展额外的具有明确复发定义的比较临床试验。证据等级 III:。