Abstract：
OBJECTIVE: The choice of surgical technique for aponeurectomy in Dupuytren\'s disease is controversial due to varying outcomes and complication rates. The Malingue plasty has shown mathematical and mechanical advantages, but long-term efficacy and results compared to other techniques have never been reported. This study aimed to evaluate the long-term functional, esthetic and recurrence outcomes of Malingue plasty in Dupuytren\'s disease.
METHODS: The study included patients who underwent aponeurectomy with Malingue plasty performed by a highly experienced surgeon between January 2014 and December 2016, with a minimum follow-up of 5 years. Preoperative records were analyzed. At follow-up, extension lag was analyzed in each joint (metacarpophalangeal, proximal interphalangeal and distal interphalangeal) in each operated finger, as well as signs of recurrence or extension of the disease. Function and esthetics were assessed using the QuickDASH (Disabilities of the Arm, Shoulder and Hand) questionnaire and the Michigan Hand Outcomes Questionnaire.
RESULTS: Out of 107 eligible patients, 55 were included in the study after exclusions and loss to follow-up. Three patients required revision surgery for recurrence during follow-up. All preoperative deformities of the proximal interphalangeal and metacarpophalangeal joints were corrected postoperatively, and no intraoperative or postoperative complications occurred. Mean extension deficit at follow-up was 18.1 °. Only the little finger showed significant loss of correction (p = 0.02). Mean QuickDASH score was 13.2 and the overall Michigan Hand Outcomes Questionnaire score was 91.8%. Recurrence affected 50% of patients according to the Leclercq criteria and 27.5% according to the Felici criteria.
CONCLUSIONS: Although Malingue plasty did not improve the recurrence rate in Dupuytren\'s disease compared with other techniques, its advantages in terms of functional improvement and complications make it an interesting surgical option.
METHODS: The study included patients who underwent aponeurectomy with Malingue plasty performed by a highly experienced surgeon between January 2014 and December 2016, with a minimum follow-up of 5 years. Preoperative records were analyzed. At follow-up, extension lag was analyzed in each joint (metacarpophalangeal, proximal interphalangeal and distal interphalangeal) in each operated finger, as well as signs of recurrence or extension of the disease. Function and esthetics were assessed using the QuickDASH (Disabilities of the Arm, Shoulder and Hand) questionnaire and the Michigan Hand Outcomes Questionnaire.
RESULTS: Out of 107 eligible patients, 55 were included in the study after exclusions and loss to follow-up. Three patients required revision surgery for recurrence during follow-up. All preoperative deformities of the proximal interphalangeal and metacarpophalangeal joints were corrected postoperatively, and no intraoperative or postoperative complications occurred. Mean extension deficit at follow-up was 18.1 °. Only the little finger showed significant loss of correction (p = 0.02). Mean QuickDASH score was 13.2 and the overall Michigan Hand Outcomes Questionnaire score was 91.8%. Recurrence affected 50% of patients according to the Leclercq criteria and 27.5% according to the Felici criteria.
CONCLUSIONS: Although Malingue plasty did not improve the recurrence rate in Dupuytren\'s disease compared with other techniques, its advantages in terms of functional improvement and complications make it an interesting surgical option.
摘要：
目的：由于不同的结局和并发症发生率，Dupuytren病aponeurect的手术技术选择存在争议。Malingue成形术显示出数学和机械优势，但与其他技术相比的长期疗效和结果从未被报道。本研究旨在评估长期功能，Dupuytren病的麦芽成形术的美学和复发结局。
方法：该研究包括在2014年1月至2016年12月期间由经验丰富的外科医生进行的马林格成形术的患者，至少随访5年。分析术前记录。在后续行动中,分析了每个关节的伸展滞后(掌指骨，近端指间和远端指间)在每个操作的手指,以及疾病复发或扩展的迹象。使用QuickDASH(手臂残疾，肩和手)问卷和密歇根手结果问卷。
结果：在107名符合条件的患者中，55人在排除和失去随访后被纳入研究。三名患者在随访期间需要进行翻修手术以复发。术前所有近端指间和掌指关节畸形均在术后矫正。术中、术后无并发症发生。随访时的平均延伸缺陷为18.1°。只有小指显示出校正的显著损失(p=0.02)。平均QuickDASH得分为13.2，总体密歇根手结果问卷得分为91.8%。根据Leclercq标准，复发影响了50％的患者，根据Felici标准，复发影响了27.5％的患者。
结论：尽管与其他技术相比，Malingue成形术并未改善Dupuytren病的复发率，它在功能改善和并发症方面的优势使其成为一种有趣的手术选择。
方法：该研究包括在2014年1月至2016年12月期间由经验丰富的外科医生进行的马林格成形术的患者，至少随访5年。分析术前记录。在后续行动中,分析了每个关节的伸展滞后(掌指骨，近端指间和远端指间)在每个操作的手指,以及疾病复发或扩展的迹象。使用QuickDASH(手臂残疾，肩和手)问卷和密歇根手结果问卷。
结果：在107名符合条件的患者中，55人在排除和失去随访后被纳入研究。三名患者在随访期间需要进行翻修手术以复发。术前所有近端指间和掌指关节畸形均在术后矫正。术中、术后无并发症发生。随访时的平均延伸缺陷为18.1°。只有小指显示出校正的显著损失(p=0.02)。平均QuickDASH得分为13.2，总体密歇根手结果问卷得分为91.8%。根据Leclercq标准，复发影响了50％的患者，根据Felici标准，复发影响了27.5％的患者。
结论：尽管与其他技术相比，Malingue成形术并未改善Dupuytren病的复发率，它在功能改善和并发症方面的优势使其成为一种有趣的手术选择。
