Hohendorff, B., Biber, F., Sauer, H., Ries, C., Spies, C. and Franke, J. (2016). Supplementary arthrolysis of the proximal interphalangeal joint of fingers in surgical treatment of Dupuytren's contracture. Oper. Orthopade Traumatol., 28 (1). S. 4 - 12. MUNICH: URBAN & VOGEL. ISSN 1439-0981

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Abstract

Objective. Correction of residual flexion deformity of the proximal interphalangeal (PIP) joint after excision of diseased connective tissue in Dupuytren's contracture by stepwise arthrolysis. Indications. Flexion deformity of the PIP joint of 20 degrees or more after excision of the diseased connective tissue in Dupuytren's contracture. Contraindications. Joint deformities, osteoarthrosis, intrinsic muscle contracture, instability of the PIP joint. Surgical technique. Arthrolysis of the PIP joint is performed by six consecutive steps: dissection of the remaining skin ligaments, opening the flexor tendon sheath by transverse incision at the distal end of the A2 pulley, dissection of the checkrein ligaments, dissection of the accessory collateral ligaments, releasing the palmar plate proximally, releasing the palmar plate up to its insertion at the middle phalanx base. Postoperative management. Dorsal plaster of Paris with extended fingers and compressive dressing in the palm for 2 days, occupational/physical therapy, static and possible dynamic extension splint several weeks/months. Results. A total of 31 fingers in 28 patients with Dupuytren's contracture were evaluated an average of 22 months after arthrolysis of the PIP joint. In all, 26 joints with an average recurrent flexion contracture of 29 degrees were improved compared to the preoperative flexion contracture of 81 degrees; 4 PIP joints with a recurrent flexion contracture averaging 60 degrees were worse. In one patient, PIP flexion contracture of 90 degrees was unchanged at follow-up although the joint could be extended intraoperatively to 10 degrees of flexion.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hohendorff, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Biber, F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sauer, H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ries, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spies, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Franke, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-285048
DOI: 10.1007/s00064-015-0427-3
Journal or Publication Title: Oper. Orthopade Traumatol.
Volume: 28
Number: 1
Page Range: S. 4 - 12
Date: 2016
Publisher: URBAN & VOGEL
Place of Publication: MUNICH
ISSN: 1439-0981
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CAPSULOLIGAMENTOUS RELEASE; DISEASEMultiple languages
OrthopedicsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/28504

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