Patients with severe recurrent Dupuytren\'s disease of the little finger (Tubiana stage III/IV) were treated with proximodistal interphalangeal arthrodesis, combined with limited fasciectomy. Range of motion was assessed preoperatively and postoperatively. QuickDASH and a VAS were assessed to determine overall function and pain respectively. Radiographic evaluation was made at 6 and 12 weeks postoperatively.
Thirteen patients were eligible for inclusion. Mean age was 69 years (range 49-87). Radiographic consolidation was obtained at a mean 58 days (range 27-97). Full extension of the metacarpophalangeal joint was achieved in 11 patients and full adduction in 12. Mean active flexion was 94° (range 90-100). QuickDASH scores decreased from 18 to 12 after surgery. Pain scores were low and unchanged.
By combining proximodistal interphalangeal arthrodesis with limited fasciectomy through a volar approach, finger extension improved, and fixed abduction was also treated. The combined volar and dorsal approach did not induce vascular impairment or other complications.
方法:对患有严重复发性小指Dupuytren病(TubianaIII/IV期)的患者进行近端远端指间关节固定术治疗,结合有限的筋膜切除术。术前和术后评估活动范围。分别评估QuickDASH和VAS以确定总体功能和疼痛。术后6周和12周进行影像学评估。
结果:13例患者符合入选条件。平均年龄为69岁(范围49-87)。在平均58天(范围27-97)获得了影像学巩固。11例患者实现了掌指关节的完全伸展,12例实现了完全内收。平均主动屈曲为94°(范围90-100)。手术后QuickDASH评分从18降至12。疼痛评分较低且无变化。
结论:通过掌侧入路结合近端远端指间关节固定术和有限的筋膜切除术,手指延伸改进,固定绑架也得到了治疗。掌侧和背侧联合入路未引起血管损伤或其他并发症。