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[掌腱膜挛缩症:流行病学、诊断、治疗及预后]

[Dupuytren's disease : Epidemiology, diagnosis, treatment, outcome].

作者信息

Harbrecht A, Honigmann P, Löw S, Müller L P, Unglaub F, Spies C K

机构信息

Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Schwerpunkt für Unfall‑, Hand- und Ellenbogenchirurgie, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

Hand- und periphere Nervenchirurgie, Klinik für Orthopädie und Traumatologie des Bewegungsapparates, Kantonsspital Baselland, 4101, Bruderholz, Liestal, Laufen, Schweiz.

出版信息

Orthopadie (Heidelb). 2024 Nov;53(11):893-902. doi: 10.1007/s00132-024-04553-z. Epub 2024 Sep 25.

Abstract

Dupuytren's contracture is a fibroproliferative systemic disease that cannot be stopped by medication. The overall prevalence is 7-8%. Men are affected 3-4 times more frequently. The cause of the disease is not known. A genetic disposition and thus familial clustering are being discussed. Risk factors for the development of a Dupuytren's contracture are work-related stress (microtrauma), nicotine and alcohol consumption, epilepsy and diabetes mellitus as well as advanced age. The prognosis is poor in cases with a positive family history, bilateral involvement, age < 50 years and male gender. Several treatment options are available. Conservative therapy has no lasting benefit. Minimally invasive procedures include partial needle aponeurectomy or the injection of collagenase. Surgical procedures range from partial aponeurectomy to dermatoaponeurectomy. The recurrence risk of the gold standard treatment of surgery (partial aponeurectomy) is 20.9%.

摘要

杜普伊特伦挛缩症是一种纤维增生性全身性疾病,药物治疗无法阻止其发展。总体患病率为7%-8%。男性患病几率是女性的3至4倍。病因尚不明确。目前正在探讨遗传易感性以及家族聚集性。引发杜普伊特伦挛缩症的风险因素包括工作压力(微创伤)、吸烟、饮酒、癫痫、糖尿病以及高龄。家族史阳性、双侧受累、年龄小于50岁以及男性患者的预后较差。有多种治疗方案可供选择。保守治疗并无持久疗效。微创手术包括部分腱膜针刺切除术或注射胶原酶。手术治疗范围从部分腱膜切除术到皮肤腱膜切除术。手术(部分腱膜切除术)这一金标准治疗方法的复发风险为20.9%。

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