Mollica Q, Restuccia G, Gensini A
Ital J Orthop Traumatol. 1980 Aug;6(2):219-34.
The writers first describe the main features of the pathological anatomy and clinical characteristics of Dupuytren's contracture. They classify the lesions by Tubiana's method, which is eminently objective and practical. This classification divides the lesions, according to their severity, in five stages: 0, 1, 2, 3, 4. The surgical technique of total aponeurectomy used by the authors is described. The total case material is thirty patients, with thirty-three hands operated on. By comparing the state of the hand before and after operation, the degree of improvement was calculated as a percentage derived from Tubiana's method of classification. A careful evaluation of the results confirms the validity of the therapeutic approach adopted. The indications and prognosis depend on the severity of the initial lesions. In general the chances of cure are good up to stage 3; but once this stage has been passed, and especially if hyperextension of the terminal phalanx is present, there is a high probability of recurrence and failure. In these cases they advise against corrective surgery and consider arthrodesis or amputation a more suitable alternative.
作者首先描述了掌腱膜挛缩症的病理解剖主要特征和临床特点。他们采用图比阿纳（Tubiana）法对病变进行分类，该方法极为客观且实用。这种分类根据病变严重程度将其分为五个阶段：0期、1期、2期、3期、4期。文中描述了作者所采用的全腱膜切除术的手术技巧。总病例材料为30例患者，共33只手接受了手术。通过比较手术前后手部的状态，按照图比阿纳分类法计算改善程度的百分比。对结果的仔细评估证实了所采用治疗方法的有效性。适应证和预后取决于初始病变的严重程度。一般来说，3期及以前治愈的机会良好；但一旦超过这个阶段，尤其是如果末节指骨存在过伸情况，复发和治疗失败的可能性就很高。在这些情况下，他们建议不要进行矫正手术，而认为关节融合术或截肢术是更合适的选择。
