Universität zu Köln

Spies, Christian K., Hahn, Peter, Mueller, Lars P., Loew, Steffen, Sellei, Richard M. and Oppermann, Johannes (2016). The efficacy of open partial aponeurectomy for recurrent Dupuytren's contracture. Arch. Orthop. Trauma Surg., 136 (6). S. 881 - 890. NEW YORK: SPRINGER. ISSN 1434-3916

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Abstract

To evaluate the efficacy of open partial aponeurectomy for recurrent Dupuytren's contracture. Eighteen patients with recurrent Dupuytren's contracture of 22 fingers were retrospectively assessed with a mean follow-up time of 94 months (range: 70-114 months). Examination parameters included the determination of range of motion (ROM), grip strength, pain and subjective outcome (disabilities of the arm, shoulder and hand (DASH) questionnaire). Dissection with special regard to former skin incision and expected wound defect. Modified incisions after Bruner (Mini-Bruner incisions) were facilitated. Dissection started at the palm. Fibrous tissue was resected proximally within the palm including vertical fibrotic septae. Direct preparation of the neurovascular bundles (NVB) was facilitated from proximal to distal. If the anatomy of the neurovascular structures became unclear around the natatory ligament preparation of the NVB at the distal end of the fibrous cord was performed. After complete preparation of a NVB, dissection was continued from medial to lateral until the other bundle was completely released. Transposition flaps and skin transplants were often used for sufficient wound closure. Recurrence rate was 36 % applying the definition of van Rijssen et al. Fifteen patients had a grip strength of 90 % or higher in comparison to the contralateral side. Ten patients had a pinch strength of 90 % or higher in comparison to the contralateral side. All patients except for one had pain reduction or none postoperatively. Fifteen patients had a DASH score of 15 or lower (range: 0-47). An unrelated ray amputation was suffered due to wound healing complications. Open partial aponeurectomy performed by a board certified hand surgeon proved to be safe. The postoperative functional outcome seemed to be related to the individual course of the disease.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Spies, Christian K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahn, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Loew, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Sellei, Richard M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Oppermann, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-273968
DOI:	10.1007/s00402-016-2448-2
Journal or Publication Title:	Arch. Orthop. Trauma Surg.
Volume:	136
Number:	6
Page Range:	S. 881 - 890
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1434-3916
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COLLAGENASE CLOSTRIDIUM-HISTOLYTICUM; PERCUTANEOUS NEEDLE APONEUROTOMY; DISEASE; COMPLICATIONS; DEFINITIONS; FASCIOTOMY; SAFETY; TUMORS; TERM Multiple languages Orthopedics; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27396