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Clinical Analysis of Dupuytren
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Objective: To investigate elderly metacarpophalangeal joint contracture outcome. Methods: Surgical finger metacarpophalangeal joint contracture ligament resection, early postoperative functional exercise with the therapy. Results: After six months to 1 year of follow-up results: excellent in 7 cases, good in 4 cases, in 1 case, poor 0 case. Conclusion: Surgical removal of the metacarpophalangeal joint collateral ligament, early postoperative physical therapy with physical therapy to restore function of the metacarpophalangeal joint flexion and extension, the effect is excellent.
【Author】: Xuzhou City, Jiangsu Province, the Fourth People's Hospital of Orthopaedics! 221009
Key words: metacarpophalangeal joint; contracture; elderly; Craven's Fracture
【Keywords】: R683.41
】 【DOI: cnki: ISSN :37-1247 .0.2000-03-014
Snapshot】 【text:
Craig's older fractures occurred more opportunities, but Craig's fracture closed reduction, external fixation after metacarpophalangeal joint contracture caused by the rigid case is not rare; July 1997 ~ July 1998, 12 cases of our department metacarpophalangeal joint contracture surgery for patients treated with systemic immediate postoperative rehabilitation, to achieve better results. 1 Data and methods 1.1 General Information The group of 12 patients, 3 males, 9 females, aged 52 to 67 years, mean 56 years old. Craig's 12 patients were due to fracture of plaster fixation, removal of plaster, straight bit of metacarpophalangeal joint flexion deformity can not. This group of patients were in the doctor explain how the workout, functional exercise for home, the time for the 6 months to 1 year and can not restore the hand metacarpophalangeal joint flexion and extension activities, to hospital while the patient received surgical treatment. 1 .
Objective: To study the result of operation of metacarpophalangeal joints contracture in old people's. Methods: Contractive ligament functional excercise metacarpophalangeal of articulation of finger were resected, early and physical therapy after operation were instructed. Results: The patients were followed up from 0.5 to 1 years, excellent result was obtaioned in 7 cases, good in 4, fair in 1, and poor in 0. Conclusions: The ligament of metacarpophalangeal articulation are resected and physical therapy after operation can recover extention flexion movement of the metacarpophalangeal joints, clinical results is good.
【Keyword】: Metacarpophalangeal joints Contracture of ligament Old people's Colles fraceture
Current location: China paper Download Center> Medicine> Clinical> text elderly Dupuytren Surgical treatment of 55 cases
Source: China paper Download Center [10-09-10 16:51:00] Author: Yang Bo Shan Chen Li Editor: studa20
Early this disease can be physical therapy, local injection of hydrocortisone and vitamin E, radiation therapy and other methods to control disease progression. Which radiation therapy can effectively curb the development of early Dupuytren 〔7〕. Surgery remains an effective solution method for Dupuytren 〔8〕, divided into the palm aponeurosis transection, partial excision of palmar fascia, palmar aponeurosis total resection surgery, cut refers to the technique. ① palm aponeurosis amputation: its treatment is not thorough, easy to relapse, is now rarely used clinically. ② partial resection of palmar fascia: the patients were treated by this method. Contracture to do with the place in the "Z"-shaped incision or a longitudinal incision "Z" word to change shape, cut to be longer than the contracture area. Sharp dissection the subcutaneous tissue and aponeurosis contracture, from health organizations began to look for and to protect the tendon next to the neurovascular bundle. Aponeurosis contracture and removal of affected skin, involvement refers to straight buckling risk. A small number of patients due to history a long time, contracture of the neurovascular bundle, can not fully straighten the fingers. Large skin defect, can not be directly possible closure of free skin grafting. ③ All palm aponeurosis resection: major trauma patients, the small scope. ④ section refers to the technique: only function in the elderly and patients that the patients can not be restored.
Surgery should be noted: ① palm aponeurosis superficial by the thickening of deep fascia of hand made, in the middle of the palm is divided into three parts. Easy to form Dupuytren which is the central aponeurosis, which consists of thick, strong fibrous structure, is a longitudinal, transverse, and vertical structure of complex three-dimensional fiber to the distal aponeurosis to form the metacarpophalangeal and fingers aponeurosis. Is apt to cause disease in the palm of longitudinal fibers and transverse fibers between the finger web and sent to the deep vertical fibers 〔9〕. Where particular attention is given to the deep vertical fibers, because of contracture of the neurovascular bundle easily when surrounded, cut to the attention of non-invasive operation, to avoid the damage of a nerve. In addition, the cut should be thoroughly and avoid recurrence. The patients, 1 recurrence, reoperation after total excision of the vertical fibers, no recurrence. ② design and choice of incision: Dupuytren's design and choice of incision is very important. Principle is the complete removal of the lesion based on the contracture of the palmar aponeurosis, to maximize the protection of the blood supply at the skin incision, protection of the surrounding neurovascular bundles. There McIndeo method commonly used incision, Tubiana law, King Law, Skoog law, straight incision "Z" word reshaping law. This group of patients with individual cases, the use of McIndeo straight incision method or "Z" to change the word method, without postoperative skin necrosis, vascular complications such as nerve injury.
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9 Qin Jianjun, Zhao Jin Choi. Palmar aponeurosis part of the resection of 17 cases of Dupuytren 〔J〕. Journal of Hand Surgery, 2007; 3 (21): 52. Reposted elsewhere in the paper for free download http://www.studa . net
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