Two-stage treatment of severe Dupuytren’s contracture with an external fixator

Золотов, А. С.

doi:10.1177/1753193419865716

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…By slow continuous distraction of the retracted finger joints, any sudden stretching and tearing of the shortened neurovascular bundles is avoided. Abrupt and harsh stretching of the finger vessels is one of the main causes of devascularization and ischemic disorders, with possible subsequent necrosis, sensation loss, and, ultimately, finger loss [ 13 , 22 , 24 ]. Furthermore, staged approaches with distraction of severely contracted joints, followed by fasciectomy, have been shown to minimize complication rates [ 22 , 25 ].…”

Section: Introductionmentioning

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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Section: Introductionmentioning

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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“…In recurrent contracture, the risk for complications on reoperation increases significantly because of scar tissue formation, which can sometimes even become a reason for finger amputation [3][4][5] . In severe recurrent contracture when the finger almost touches the palm (hooked deformity), gradual correction of the interphalangeal joint contractures with an external fixator may be considered to avoid neurovascular complications due to sudden surgical soft-tissue distraction 6 .…”

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confidence: 99%

Spectacular Accidental Distraction Arthroplasty in Dupuytren Contracture with Good Outcome

Degreef

Hoecke

Nuffel

2022

JBJS Case Connector

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Case:An exceptional event occurred during gradual extension with an external fixator for recurrent small finger Dupuytren flexion deformity. A massive proximal interphalangeal joint distraction arose, possibly because of the center of rotation misalignment and a hasty patient-controlled correction. The device was removed, and a plaster splint protected the finger for 5 days to prevent dislocation of the unstable joint. It relocated with an acceptable clinical result.Conclusion:Gradual extension of Dupuytren contractures with an external fixator may induce severe joint distraction by eccentric placement of the device. On the other hand, the good outcome of this case report may inspire further research on controlled joint distraction in hooked deformity.

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Hypnotherapy in the treatment of Dupuytren's disease with collagenase: our center's experience beyond the guidelines

BERTOLINI,

FACCENDA,

GIACALONE

et al. 2024

Minerva Orthop

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Two-stage treatment of severe Dupuytren’s contracture with an external fixator

Cited by 4 publications

References 4 publications

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

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

Spectacular Accidental Distraction Arthroplasty in Dupuytren Contracture with Good Outcome

Hypnotherapy in the treatment of Dupuytren's disease with collagenase: our center's experience beyond the guidelines

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