Abstract
Dupuytren disease (DD) is a challenging clinical problem even with primary surgical cases. However, in the face of recurrence, the surgeon is frequently left with a more challenging and complex problem. Soft tissues may be more adherent because of scar formation, and the anatomy may be distorted making identification of structures such as the nerves and vessels more problematic. Furthermore, the flexor pulley system can be damaged while trying to remove some of these recurrent cords and adherent scar risking potential bow-stringing of the flexor tendons. This chapter outlines some of the options for reoperation on recurrent DD. This type of surgery takes not only skill, but extreme patience on the part of the surgeon as the dissection can be quite tedious. Fortunately, patients are usually grateful for the improvement in function that is obtained.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Calandruccio JH. Dupuytren contracture. Chap. 72 in Part XVIII: “The hand”. In: Canale ST, Beaty JH, editors. Campbell’s operative orthopaedics. 11th ed. Philadelphia: Mosby Elsevier; 2008. p. 4273–84.
Russ R. The surgical aspects of Dupuytren’s contraction. Am J Med Sci. 1908;135:856.
Rayan GM. Dupuytren disease: anatomy, pathology, presentation, and treatment. J Bone Joint Surg Am. 2007;89:189–98.
Rodrigo JJ, et al. Treatment of Dupuytren’s contracture. Long-term results after fasciotomy and fascial excision. J Bone Joint Surg. 1976;58(3):380–7.
Rousch TF, Stern PJ. Results following surgery for recurrent Dupuytren’s disease. J Hand Surg [Am]. 2000;25:291–6.
Ketchum LD, Hixson FD. Dermofasciectomy and full-thickness grafts in the treatment of Dupuytren’s contracture. J Hand Surg [Am]. 1987;12:659–64.
van Rijssen AL, et al. A comparison of the direct outcomes of percutaneous needle fasciotomy and limited fasciectomy for Dupuytren’s disease: a 6-week follow-up study. J Hand Surg. 2006;31A(5):717–25.
Van Russen AL, Werker PMN. Percutaneous needle fasciotomy in Dupuytren’s disease. J Hand Surg. 2006;31(5):498–501.
Cools H, Verstreken J. The open palm technique in the treatment of Dupuytren’s disease. Acta Orthop Belg. 1994;60(4):413–20.
Gonzalez RI. Dupuytren’s contracture of the fingers: a simplified approach to surgical treatment. California Medicine. West J Med. 1971;115(2):25–31.
Hurst LC, et al. Injectable collagenase Clostridium histolyticum for Dupuytren’s contracture. New Engl J Med. 2009;361(10):968–79.
McFarlane RM, McGrouther DA, Flint MH, editors. Dupuytren’s disease: biology and treatment. Edinburgh: Churchill Livingstone; 1990.
Badalamente M, et al. Collagen as a clinical target: nonoperative treatment of Dupuytren’s disease. J Hand Surg. 2002;27A(5):788–98.
Badalamente M, Hurst L. Efficacy and safety of injectable mixed collagenase subtypes in the treatment of Dupuytren’s contracture. J Hand Surg. 2007;32A(6):767–74.
Boyer MI, Gelberman RH. Complications of the operative treatment of Dupuytren’s disease. Hand Clin. 1999;15(1):161–6, viii.
Chung KC, Segalman KA. Microvascular solution for vascular complication in surgery for Dupuytren’s contracture: a case report. J Hand Surg Am. 1996;21(4):711–3.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Calandruccio, J.H., Hecox, S.E. (2012). Reoperative Dupuytren Contracture. In: Duncan, S. (eds) Reoperative Hand Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-2373-7_2
Download citation
DOI: https://doi.org/10.1007/978-1-4614-2373-7_2
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-2372-0
Online ISBN: 978-1-4614-2373-7
eBook Packages: MedicineMedicine (R0)