Extensive fasciectomy was performed in stage III diseases with multi-digit damage and extreme deformities. The majority of cases (90%) underwent regional fascictomia. These patients usually had stage III disease with contractures between 30 and 90 ° and in one or more digits. Home treatment and physiotherapy are important for the success of your surgery. After the operation, the hand is wrapped and immobilized in a large, bulky “boxing glove” type pressure bandage, which is usually removed three to five days after the operation. Surgical wounds can heal slowly and sometimes resolve during the rehabilitation process. Doctors and therapists will monitor this closely to balance the wound care, movement and splint program. Dupuytren`s disease is one of the fibroproliferative diseases that affect the palmar and digital fascia. It affects both hands with the same frequency and is usually heavier in one hand. Most often, the ring finger is involved, followed by the little finger. This disease has been known to surgeons for at least 200 years and is treated by them [1-4]. Plater (1614) is credited with the first account of the disease, and Cline (1777) and Sir Astley Cooper described finger contracture and suggested treatment with subcutaneous fasciotomy.
However, in 1831, Dupuytren remained to describe the anatomy, to clearly state that the disease was in the palmar fascia, and to propose treatment with open fasciotomy [5-7]. Proper correction may require joint release after resection of contracted and diseased tissue. Shortening of neurovascular bundles may also limit post-release expansion with long-term PIP contracture. Due to these technical challenges, complete correction is less common and persistence of joint flexion contracture is more likely. [4, 5] Villani F, Choughri H, Pelissier P. [Importance of skin grafting in preventing recurrence of Dupuytren`s contracture]. Chir Main. 2009 December 28 (6):349-51. [Medline]. Heuston JT.
Control of recurrent Dupuytren contracture by skin replacement. Br. J Plast Surg. 1969 Apr. 22 (2):152-6. [Medline]. Demonstration of Dupuytren`s ligament and bumps during surgery The goal of surgery in Dupuytren`s contracture is to regain the maximum function of the hand instead of completely curing the disease. If there is no deformation and no loss of hand function, the operation may be delayed until a significant deformation has developed. Therefore, the small palmar node rarely needs surgery unless it is tender enough to interfere with activities. Decisions in the skin incision are important for skin management. Longitudinal sections such as multiple Y-V feeding lobes, Bruner`s zigzag incision [13] and median longitudinal sections closed with Z plastics are more popular and have the advantage of progressive flexible exposure and treatment of skin deficiency after contracture. On the other hand, transverse incisions (long palmar incision and short digital incisions) are beneficial because they are less likely to be a pathway for subsequent scar contracture.
In the Open Palm technique popularized by McCash [14], transverse skin incisions inaccessible to primary closure were treated with full-thickness skin graft closure or secondary wound healing. Xiaflex™ is a prescription drug used to treat adults with Dupuytren`s contracture when a “string” can be felt. Possible complications Open surgery and needle apanobotomy have a high recurrence rate of contractures. Even open surgery can lead to an exaggerated reaction to the wound. Dupuytren`s disease (say “duh-pwee-TRAHNZ”) is an abnormal thickening of the tissue under the skin in the palm of the hand. The first symptom is often a small bump (knot) in the palm of the hand, often near the base of the finger. In some people, a fibrous cord may form in the palmar tissue. The cord pulls the finger towards the palm. This is called Dupuytren`s contracture. Dupuytrens contracture release surgery is a treatment designed to correct Dupuytren contracture, a condition that usually begins with thickening of the skin in the palm of the hand. Eventually, the disease can develop into a thick strip that could contract your fingers or pull them into the palm of your hand.
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