Segmental aponeurectomy with Z-Plasty as a treatment option in Dupuytren's disease: A retrospective cohort study

Gardeil, Ludivine; Parrat, Valérie Matter; Portenard, Anne Carole; Coquerel, D.; Bonmarchand, Albane; Auquit-Auckbur, I.

doi:10.1016/j.otsr.2019.08.016

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…Despite recent advances, the process of proliferation of (myo-) fibroblasts is not yet understood [ 34 , 35 , 36 , 37 , 38 , 39 ] and methods of tissue engineering and regenerative medicine to replace resected tissue and skin are promising, but are still not clinically available [ 37 ]. While MCP contracture may be well addressed with segmental palmar aponeurectomy with Z-plasty [ 40 ], PIP and DIP joint contractures are more difficult to treat [ 41 ]. In an anatomical study, severe secondary damage to lateral and dorsal structures was observed, and these changes may explain the poor results of corrective surgery to this joint in DD [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

A Personalized Approach to Treat Advanced Stage Severely Contracted Joints in Dupuytren’s Disease with a Unique Skeletal Distraction Device—Utilizing Modern Imaging Tools to Enhance Safety for the Patient

Müller‐Seubert

Cai

Arkudas

et al. 2022

JPM

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Background: While surgical therapy for Dupuytren’s disease is a well-established standard procedure, severe joint flexion deformities in advanced Dupuytren’s disease remain challenging to treat. Skeletal distraction has proven to be an additional treatment option. Methods: We analyzed the surgical treatment algorithm, including the application of a skeletal distraction device, in patients with a flexion deformity due to Dupuytren’s disease, Iselin stage III or IV, who were operated on from 2003 to 2020 in our department. Results: From a total of 724 patients, we included the outcome of 55 patients’ fingers in this study, who had undergone additional skeletal joint distraction with our Erlangen device. Additional fasciotomy or fasciectomy, in a one- or two-staged procedure, was performed in all patients, according to the individual findings and necessities. The range of motion of the PIP joint improved from 12° to 53°. A number of complications, in all steps of the treatment, were noted in a total of 36.4% of patients, including the development of fractures (16.4%), followed by vessel injury, pin infections, and complex regional pain syndrome (5%). Conclusions: Additional skeletal distraction improves the range of motion of severely contracted joints in Dupuytren’s disease. Nevertheless, careful patient selection is necessary, due to the moderate rate of complications.

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