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Results of total aponeurectomy for Dupuytren’s contracture in 61 patients: a retrospective clinical study

  • Orthopaedic Surgery
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Abstract

Introduction

Many surgical techniques have been advocated to treat Dupuytren’s contracture. Partial fasciectomy is often performed to treat the whole spectrum of Dupuytren’s disease.

Method

We have reviewed the effectiveness of total aponeurectomy performed on 61 patients [10 women and 51 men (male:female ratio 5.1:1) with a mean age of 63.0 (range 42–79 years) and a mean follow-up of 3.45 years (range 1.03–6.39 years)].

Results

Post-operative complications including haematoma, seroma or necrosis were found in 13.8% of the patients. Recurrence of contracture occurred in 10.8% of the patients and 4.6% of the operated patients presented with a nerve lesion. Nerve irritation occurred in 6.2% of the patients. The mean DASH-score was 3.85 (range 0–52.5). Family pre-disposition was an important risk factor for Dupuytren’s disease with 44.3% of patients having a positive family history.

Conclusion

We suggest that total aponeurectomy is a promising alternative to partial fasciectomy with low risk for a recurrence and slightly increased risk for a nerve lesion.

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References

  1. American Society for Surgery of the Hand (1983) The Hand. Examination and diagnosis, 2nd edn. Churchill Livingstone, Edinburgh

    Google Scholar 

  2. Armstrong JR, Hurren JS, Logan AM (2000) Dermofasciectomy in the management of Dupuytren’s disease. J Bone Joint Surg Br 82B:90–94

    Article  Google Scholar 

  3. Berger A, Flory PJ, Brenner P (1990) Clinical aspects and surgical treatment of Dupuytren contracture. Unfallchirurg 93:181–185

    PubMed  CAS  Google Scholar 

  4. Brenner P, Krause-Bergmann A, Van VH (2001) Die Dupuytrensche Kontraktur in Norddeutschland—Epidemiologische Erfassungsstudie an Hand von 500 Fällen. Unfallchirurg 104:303–311

    Article  PubMed  CAS  Google Scholar 

  5. Brenner P (2002) Dupuytren’s disease of ring and little finger. Orthop Traumatol 10:138–158

    Article  Google Scholar 

  6. Brenner P, Rayan GM (2003) Morbus Dupuytren: Ein chirurgisches Therapiekonzept, 1st edn edn. Springer, New York, p 28

    Google Scholar 

  7. Clibbon JJ, Logan AM (2001) Palmar segmental aponeurectomy for Dupuytren’s disease with metacarpophalangeal flexion contracture. J Bone Joint Surg [Br] 26:360–361

    CAS  Google Scholar 

  8. Coert JH, Barret Nérin JP, Meek MF (2006) Results of partial fasciectomy for Dupuytren’s disease in 261 consecutive patients. Ann Plast Surg 57:13–17

    Article  PubMed  CAS  Google Scholar 

  9. De Maglio A, Timo R, Feliziani G (1996) Recidive ed estensioni nel morbo di Dupuytren trattato con aponeurectomia selettiva. Revisioni clinica di 124 casi. Chir Organi Mov 86:43–48

    Google Scholar 

  10. Germann G, Wind G, Harth A (1999) Der DASH-Fragebogen–Ein neues Instrument zur Beurteilung von Behandlungsergebnissen an der oberen Extremität. Handchir Mikrochir Plast Chir 31:149–152

    Article  PubMed  CAS  Google Scholar 

  11. Hueston JT (1968) Dupuytren’s contracture and specific injury. Med J Aust 1:1084–1085

    PubMed  CAS  Google Scholar 

  12. Iselin F, Cardenas-Baron L, Gouget-Audry I, Peze W (1988) La maladie de Dupuytren dorsale. Ann Chir Main 7:247–250

    Article  PubMed  CAS  Google Scholar 

  13. Langenberg R (1987) Dupuytren’s contracture - is partial palmar aponeurectomy still justifiable? Zentralbl Chir 112:769–775

    PubMed  CAS  Google Scholar 

  14. Makela EA, Jaroma H, Harju A, Anttila S, Vainio J (1991) Dupuytren’s contracture: the long term results after day surgery. J Hand Surg [Br] 16:272–274

    CAS  Google Scholar 

  15. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S (1985) Grip and pinch strength: normative data for adults. Arch Physical Med Rehab 66:69–74

    CAS  Google Scholar 

  16. McGrouther DA (1999) Dupuytren’s contracture. In: Green DP, Hotchkiss RN, Pederson WC (eds) Green’s operative hand surgery. Churchill Livingstone, London, pp 563–591

    Google Scholar 

  17. Norotte G, Apoil A, Travers V (1988) Résultat à plus de dix ans de la maladie de Dupuytren A propos de cinquante-huit observations. Ann Chir Main 7:277–281

    Article  PubMed  CAS  Google Scholar 

  18. Rayan GM (2007) Dupuytren disease anatomy, pathology, presentation, and treatment. J Bone Joint Surg Am 89:189–198

    PubMed  Google Scholar 

  19. Robins RH, Scott TD, Griffiths DP (1993) Day care surgery for Dupuytren’s contracture. J Hand Surg [Br] 18:494–498

    CAS  Google Scholar 

  20. Rodrigo JJ, Niebauer JJ, Brown RL, Doyle JR (1976) Treatment of Dupuytren’s contracture. Long-term results after fasciotomy and fascial excision. J Bone Joint Surg [Am] 58:380–387

    CAS  Google Scholar 

  21. Skoog T (1948) Dupuytren’s contraction with special reference to ethiology and improved surgical treatment, its occurrence in epileptics, note on knuckle pads. Acta Chir Scand 96(Suppl. 139):1–190

    Google Scholar 

  22. Tonkin MA, Burke FD, Varian JP (1984) Dupuytren’s contracture: a comparative study of fasciectomy and dermofasciectomy in one hundred patients. J Hand Surg [Br] 9:156–162

    CAS  Google Scholar 

  23. Unglaub F, Wolf E, Goldbach C, Hahn P, Kroeber MW (2007) Subjective and functional outcome after revision surgery in carpal tunnel syndrome. Arch Orthop Trauma Surg

  24. Unglaub F, Loos B, Schwarz S, Kneser U, Dragu A, Horch RE (2008) Phlegmonous-infection in first degree Dupuytren’s disease. Arch Orthop Trauma Surg

  25. Zimmermann R, Sailer R, Pechlaner S, Gabl M (2003) Functional outcome with special attention to the DASH questionnaire following callus distraction and phalangization of the thumb after traumatic amputation in the middle one-third. Arch Orthop Trauma Surg 123(10):521–526

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Traumatology, Hand and Reconstructive Surgery, St.Josefs-Hospital Cloppenburg, Krankenhausstr.13, 49661, Cloppenburg, Germany

    A. Högemann & L. C. Olivier

  2. Medical Faculty, University of Duisburg–Essen, Duisburg–Essen, Germany

    U. Wolfhard

  3. Orthopaedic Department, Hospital for Special Surgery, New York, USA

    D. Kendoff

  4. Wrightington Hospital and the University of Manchester, Manchester, UK

    T. N. Board

Authors
  1. A. Högemann
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  2. U. Wolfhard
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  3. D. Kendoff
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  4. T. N. Board
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  5. L. C. Olivier
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Corresponding author

Correspondence to L. C. Olivier.

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Högemann, A., Wolfhard, U., Kendoff, D. et al. Results of total aponeurectomy for Dupuytren’s contracture in 61 patients: a retrospective clinical study. Arch Orthop Trauma Surg 129, 195–201 (2009). https://doi.org/10.1007/s00402-008-0657-z

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  • DOI: https://doi.org/10.1007/s00402-008-0657-z

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