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Is limited fasciectomy the technique of choice to treat Dupuytren’s contracture?
Keywords:
Contracture, Dupuytren, Fasciotomy, Limited fasciectomyAbstract
Objective: To determine the functional outcome of limited fasciectomy for the treatment of Dupuytren’s contracture.
Methods: This descriptive study was conducted in District Head Quarter Hospital Timergara Khyber Pakhtunkhwa and Khyber Teaching Hospital Peshawar from 21st March 2018 to 21st March 2021. All patients of Dupuytren’s contracture fulfilling the inclusion criteria were treated with limited fasciectomy (LF). Post operative functional outcome was assessed with Khan and Iqbal criteria and graded as excellent, good, fair and poor.
Results: In this study 12 patients (20 hands) were included. All patients were male. The mean age was 61.5± 7 years. The mean duration of follow up was 14.4±3(range 12 to 16 months). Excellent outcome was reported in 14(70%) hands, good in 5(25%) and fair in 1(5%) hand. No intra operative or post operative complications were noted. We reported recurrence in one hand.
Conclusion: Excellent functional outcome was achieved with limited fasciectomy in patients with Dupuytren’s contracture in our series. We recommend limited fasciectomy as the technique of choice to treat Dupuytren’s contracture.
References
Aykut S, Baydar M, Buyuk AF, Ozturk IA, Ozden E, Ozturk K. Surgical treatment results for dupuytren's disease. Acta Ortopedica Brasileira 2017;25(3):71-73.
Elliot D. The early history of Dupuytren’s disease. Hand Clin 1999;15:1-19.
Dupuytren G. De la retraction des doigts par suite d’une affection de l’aponevrose palmaire-description de la maladie-operation Chirugicale qui convient dens de cas. J Univ Hebd M´ed Chir Prat Inst Med 1831;5:349-65.
Hindocha S, McGrouther DA, Bayat A. Epidemiological evaluation of Dupuytren’s disease incidence and prevalence rates in relation to etiology. Hand (N Y)2009; 4:256-269
Cheung K, Walley KC, Rozental TD. Management of complications of Dupuytren contracture. Hand Clin 2015;31(2):345–354.
Ozkaya O, Ye?ilada AK, Kar??da? S, Soydan AT, Ugurlu K, Ba? L. Dupuytren's contracture: etiology, diagnosis and surgical treatment, retrospective analysis of ten years. Turkiye Klinikleri J Med Sc 2010;30(2):553-558.
Rodrigues JN, Becker GW, Ball C, Zhang W, Giele H, Hobby J, et al. Surgery for Dupuytren's contracture of the fingers. Cochrane Database Syst Rev 2015;12:CD010143.
Wai-Chung Chan; Siu-Ho Wan; Fu-Keung Ip. Review of Partial Fasciectomy for Dupuytren's Contracture in Southern Chinese Patients.J Orthop Truama Rehab 2012;16(2). Doi:10.1016/j.jotr.2012.09.002.
Burge P, Hoy G, Regan P, Milne R. Smoking, alcohol and the risk of Dupuytren's contracture. J Bone Joint Surg Br 1997;79(2):206-210.
Palmer KT, D'Angelo S, Syddall H, Griffin MJ, Cooper C, Coggon D. Dupuytren's contracture and occupational exposure to hand-transmitted vibration. Occup Environ Med 2014;71(4):241-245.
Crean SM, Gerber RA, Le Graverand MP, Boyd DM, Cappelleri JC .The efficacy and safety of fasciectomy and fasciotomy for Dupuytren’s contracture in European patients: a structured review of published studies. J Hand Surg Eur 2011; 36:396-407
Desai SS, Hentz VR .The treatment of Dupuytren disease. J Hand Surg Am 2011; 36:936–942.
Eaton C. Percutaneous fasciotomy for Dupuytren’s contracture. J Hand Surg Am 2011; 36:910–915.
Gerber RA, Perry R, Thompson R, Bainbridge C. Dupuytren’s contracture: a retrospective database analysis to assess clinical management and costs in England. BMC Musculoskelet Disord 2011; 12:73
Denkler, KA, Vaughn, CJ, Dolan, EL. Evidence-based medicine: options for Dupuytren’s contracture: incise, excise, and dissolve. Plast Reconstr Surg 2017;139:240-255.
Hueston JT. The table top test. Hand 1982;14:100e3.
Khan PS, Iqbal S, Zaroo I, Hayat H. Surgical Treatment of Dupuytren's Contracture; Results and Complications of Surgery: Our Experience. J Hand Microsurg. 2010;2(2):62-66.
Bergovec M, Jelicic J, Oljaca A, Bilic R. Hand function and recurrence after limited fasciectomy for Dupuytren's contracture: Long-term follow-up. J Orthop Surg (Hong Kong). 2018;26(1).Doi: 10.1177/2309499018762195.
Kitridis D, Karamitsou P, Giannaros I, Papadakis N, Sinopidis C, Givissis P. Dupuytren’s disease: limited fasciectomy, night splinting, and hand exercises-long-term results. Eur J Orthop Surg Traumatol 2019;29(2):349-355.
Selles RW, Zhou C, Kan HJ, Wouters R M, Nieuwenhoven CA, Hovius SE. Percutaneous Aponeurotomy and Lipofilling versus Limited Fasciectomy for Dupuytren’s Contracture : 5-Year Results from a Randomized Clinical Trial Plast Reconstr Surg 2018; 142(6):1523-1531.
van Rijssen AL, Gerbrandy FSJ, Linden H, Klip H, Werker PMN. 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 Am 2006;31:717-725.
Soreide E, Murad MH, Denbeigh JM, Lewallen EA, Dudakovic A, Nordsletten L, et al. Treatment of Dupuytren’s contracture-A systematic Review. Bone Joint J 2018;100-B(9):1138-1145.
Kan HJ, de Bekker-Grob EW, van Marion ES, van Oijen GW, van Nieuwenhoven CA, Zhou C, et al. Patients’preferences for treatment for Dupuytren’s disease: A discrete choice experiment. Plast Reconstr Surg 2016;137:165-173.
van Rijssen AL, ter Linden H, Werker PM. Five-year results of a randomized clinical trial on treatment in Dupuytren’s disease: Percutaneous needle fasciotomy versus limited fasciectomy. Plast Reconstr Surg 2012;129:469-477.
Hueston JT. Limited fasciectomy for Dupuytren's contracture. Plast Reconstr Surg Transplant Bull 1961:569-85.
