Results following surgery for recurrent Dupuytren's disease.
Results following surgery for recurrent Dupuytren's disease.
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复发性掌腱膜挛缩症手术后的结果。
DOI：
10.1053/jhsu.2000.jhsu25a0291
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发表时间：
2000
影响因子：
1.9
通讯作者：
Peter J. Stern
中科院分区：
文献类型：
--
作者：
Thomas F. Roush;Peter J. Stern
本研究旨在评估复发性掌腱膜挛缩症手术后的主观和客观结果。 19 名患者（28 根手指）因复发性挛缩接受了手术治疗，并进行中位 4 年（范围 1-15 年）的随访分析。 28 例复发病例中，有 17 例涉及小指，16 例患者至少具有掌腱膜掌腱膜挛缩症的一种素质。为了分析的目的，将患者分为 3 组：A 组（总主动活动范围 [TAM] < 150 度）由接受有限筋膜切除术和指间关节融合术治疗的 7 根手指组成，B 组（TAM >/= 150 度）由接受皮筋膜切除术和全层皮肤移植治疗的 8 根手指组成，C 组（TAM >/= 150 度）由13 根手指接受筋膜切除术和局部皮瓣治疗。反映术前、术后即刻和最终随访值的总主动活动范围显示，C 组（筋膜切除术和局部皮瓣）是唯一从术前（205 度）到最终随访（230 度）分析保持统计显着 TAM 改善的组。皮肤筋膜切除术和全层植皮并不能预防复发性挛缩（术前 TAM = 175 度；最终随访 TAM = 150 度）。 13 名患者的 Semmes-Weinstein 单丝测试异常，8 名患者的 2 点辨别力异常。有 3 个麻醉手指。尽管有这些发现，19 名患者中有 18 名对他们的经历无条件满意，并愿意再次接受手术。
This study was designed to assess the subjective and objective results following surgery for recurrent Dupuytren's disease. Nineteen patients (28 fingers) were treated surgically for recurrent contracture and were located for follow-up analysis at a median of 4 years (range, 1-15 years). Seventeen of 28 recurrences involved the small finger and 16 patients had at least one component of Dupuytren's diathesis. For the purpose of analysis the patients were divided into 3 groups: group A (total active range of motion [TAM] < 150 degrees ) consisted of 7 digits treated with limited fasciectomy and interphalangeal arthrodesis, group B (TAM >/= 150 degrees ) consisted of 8 digits treated with dermatofasciectomy and full-thickness skin graft, and group C (TAM >/= 150 degrees ) consisted of 13 digits treated with fasciectomy and local flaps. Total active range of motion reflecting the preoperative, immediately postoperative, and final follow-up values revealed that group C (fasciectomy and local flap) was the only group to maintain a statistically significant TAM improvement from preoperative (205 degrees ) to final follow-up (230 degrees ) analysis. Dermatofasciectomy and full-thickness skin grafting did not prevent recurrent contracture (preoperative TAM = 175 degrees; final follow-up TAM = 150 degrees ). Thirteen patients had abnormal Semmes-Weinstein monofilament testing and 8 had abnormal 2-point discrimination. There were 3 anesthetic digits. Despite these findings, 18 of the 19 patients were unconditionally satisfied with their experience and would undergo the procedure again.