PDF(Pubmed)
Abstract：
BACKGROUND: Dupuytren disease, a chronic thickening and retraction of the palmar aponeurosis of the hands, may result in permanent and progressive flexion of one or more fingers. Percutaneous needle fasciotomy is a simple method that uses a hypodermic needle usually performed under local anaesthesia. The study aim was to report the postoperative results and complications using a percutaneous approach to treat Dupuytren contracture in a consecutive series of patients with advanced Dupuytren disease, also considering the relevant medico-legal implications.
METHODS: Retrospective multicentre study of all patients with Tubiana stage 3-4 Dupuytren contracture treated with percutaneous needle aponeurotomy, with no ultrasound assistance, from 2012 to 2022. Patient demographics, disease severity, treatment-related complications, and the incidence of recurrence were identified. An overview of therapeutic treatment options has accounted for 52 relevant sources spanning the 2007-2023 time period.
RESULTS: Overall, 41.7% (N = 200) of patients were females, the mean age was 72 years (60-89), the right hand was treated in 54.2% (N = 260) of patients. The little finger was involved in 50% of the patients. The 12 months mean PED was 9°, the mean quickDASH was 8, the mean URAM 6. Minor complications were reported in 18.7% (N = 90) of patients, typically skin lacerations (83.3%) with no clinical sequelae, and no major complications were reported. Recurrence occurred in 30% (N = 144) of patients.
CONCLUSIONS: Percutaneous needle fasciotomy is safe and reliable even in patients with advanced Dupuytren disease, resulting in predictably acceptable outcome with low risk of complications.
METHODS: Retrospective multicentre study of all patients with Tubiana stage 3-4 Dupuytren contracture treated with percutaneous needle aponeurotomy, with no ultrasound assistance, from 2012 to 2022. Patient demographics, disease severity, treatment-related complications, and the incidence of recurrence were identified. An overview of therapeutic treatment options has accounted for 52 relevant sources spanning the 2007-2023 time period.
RESULTS: Overall, 41.7% (N = 200) of patients were females, the mean age was 72 years (60-89), the right hand was treated in 54.2% (N = 260) of patients. The little finger was involved in 50% of the patients. The 12 months mean PED was 9°, the mean quickDASH was 8, the mean URAM 6. Minor complications were reported in 18.7% (N = 90) of patients, typically skin lacerations (83.3%) with no clinical sequelae, and no major complications were reported. Recurrence occurred in 30% (N = 144) of patients.
CONCLUSIONS: Percutaneous needle fasciotomy is safe and reliable even in patients with advanced Dupuytren disease, resulting in predictably acceptable outcome with low risk of complications.
摘要：
背景：Dupuytren病，手掌膜的慢性增厚和收缩，可能导致一个或多个手指的永久性和进行性屈曲。经皮穿刺筋膜切开术是一种简单的方法，通常在局部麻醉下使用皮下注射针进行。该研究的目的是报告使用经皮方法治疗连续一系列晚期Dupuytren病患者的术后结果和并发症。还考虑了相关的医学法律影响。
方法：对所有Tubiana3-4期Dupuyten挛缩症患者进行回顾性多中心研究，没有超声波辅助，从2012年到2022年。患者人口统计学，疾病严重程度,治疗相关并发症,并确定了复发的发生率。在2007-2023年期间，治疗性治疗方案的概述占52个相关来源。
结果：总体而言，41.7％（N=200）的患者是女性，平均年龄为72岁（60-89岁），54.2%(N=260)的患者接受了右手治疗.50％的患者受累于小手指。12个月平均PED为9°,平均quickDASH为8，平均URAM为6。18.7%（N=90）的患者报告了轻微的并发症，典型的皮肤撕裂（83.3%），没有临床后遗症，无重大并发症报告.30％（N=144）的患者复发。
结论：经皮穿刺筋膜切开术即使在晚期Dupuytren病患者中也是安全可靠的，导致可预测的可接受的结果和低的并发症风险。
方法：对所有Tubiana3-4期Dupuyten挛缩症患者进行回顾性多中心研究，没有超声波辅助，从2012年到2022年。患者人口统计学，疾病严重程度,治疗相关并发症,并确定了复发的发生率。在2007-2023年期间，治疗性治疗方案的概述占52个相关来源。
结果：总体而言，41.7％（N=200）的患者是女性，平均年龄为72岁（60-89岁），54.2%(N=260)的患者接受了右手治疗.50％的患者受累于小手指。12个月平均PED为9°,平均quickDASH为8，平均URAM为6。18.7%（N=90）的患者报告了轻微的并发症，典型的皮肤撕裂（83.3%），没有临床后遗症，无重大并发症报告.30％（N=144）的患者复发。
结论：经皮穿刺筋膜切开术即使在晚期Dupuytren病患者中也是安全可靠的，导致可预测的可接受的结果和低的并发症风险。
