Tonkin M A, Burke F D, Varian J P
J Hand Surg Br. 1985 Oct;10(3):358-64. doi: 10.1016/s0266-7681(85)80062-0.
In one hundred patients with Dupuytren's disease, one hundred and fifty-four operations were performed. The average pre-operative proximal interphalangeal joint contracture was 42 degrees and the average percentage improvement in proximal interphalangeal joint extension at post-operative review was 41%. Fourteen amputations were performed (9.1%). The primary deformity is caused by disease involvement of the palmar fascial structures. Secondary changes may prevent correction of the deformity despite excision of the contracted fascia. The anatomy of the joint is reviewed together with the primary and secondary mechanisms of joint contracture in Dupuytren's disease. Arthrodesis, osteotomy of the proximal phalanx and joint replacement are considered as alternatives to amputation when a systematic surgical approach fails to correct the flexion contracture.
对100例掌腱膜挛缩症患者进行了154次手术。术前近端指间关节平均挛缩42度，术后复查时近端指间关节伸展平均改善率为41%。实施了14例截肢手术（9.1%）。原发性畸形是由掌部筋膜结构的疾病累及引起的。尽管切除了挛缩的筋膜，但继发性改变可能会妨碍畸形的矫正。本文回顾了关节的解剖结构以及掌腱膜挛缩症中关节挛缩的原发性和继发性机制。当系统性手术方法无法矫正屈曲挛缩时，关节融合术、近端指骨截骨术和关节置换术被视为截肢的替代方法。
