Abstract
This study was designed to assess the subjective and objective results following surgery
for recurrent Dupuytren's disease. Nineteen patients (28 fingers) were treated surgically
for recurrent contracture and were located for follow-up analysis at a median of 4
years (range, 1–15 years). Seventeen of 28 recurrences involved the small finger and
16 patients had at least one component of Dupuytren's diathesis. For the purpose of
analysis the patients were divided into 3 groups: group A (total active range of motion
[TAM] < 150°) consisted of 7 digits treated with limited fasciectomy and interphalangeal
arthrodesis, group B (TAM ≥ 150°) consisted of 8 digits treated with dermatofasciectomy
and full-thickness skin graft, and group C (TAM ≥ 150°) consisted of 13 digits treated
with fasciectomy and local flaps. Total active range of motion reflecting the preoperative,
immediately postoperative, and final follow-up values revealed that group C (fasciectomy
and local flap) was the only group to maintain a statistically significant TAM improvement
from preoperative (205°) to final follow-up (230°) analysis. Dermatofasciectomy and
full-thickness skin grafting did not prevent recurrent contracture (preoperative TAM
= 175°; final follow-up TAM = 150°). Thirteen patients had abnormal Semmes-Weinstein
monofilament testing and 8 had abnormal 2-point discrimination. There were 3 anesthetic
digits. Despite these findings, 18 of the 19 patients were unconditionally satisfied
with their experience and would undergo the procedure again. (J Hand Surg 2000; 25A:291–296,
Copyright © 2000 by the American Society for Surgery of the Hand.)
Keywords
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References
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Article info
Publication history
Accepted:
December 3,
1999
Received:
July 12,
1999
Footnotes
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
**Reprint requests: Peter J. Stern, MD, 2800 Winslow, No. 401, Cincinnati, OH 45206.
*0363-5023/00/25A02-0027$3.00/0
**J Hand Surg 2000; 25A:291–296
Identification
Copyright
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
