45例掌腱膜挛缩症临床分析

目的 探讨掌腱膜挛缩症的病变特点和治疗方法。方法 45例掌腱膜挛缩症,76只手行掌腱膜切除,手掌及手指挛缩皮肤“Z”字成形术。10只手掌腱膜及受累皮肤切除后游离植皮术,送病检查7例。结果 术后平均随访5年,仅5例复发,其余挛缩解除,疗效确定。其中15只手出现神经损伤、皮下血肿、皮片部分坏死等并发症。结论 掌腱膜挛缩症在国外为常见病,国人发病率相对较低,好发于中、老年男性,国内患者就诊时多已经形成明显挛缩,故多采用手术疗法,其效果可靠,早期手术术后效果好。

Report of 45 cases of Dupuytren' s contracture

Objective To explore the pathogenesis and treatment of Dupuytren' s contracture. Methods A total of 76 hands of 45 cases of Dupuytren's contracture were studied retrospectively. All cases were surgically treated and pathological examination was performed in 7 cases. Excision of the palmar aponeurosis plus "Z" shape skin plasty was performed on 66 hands and resection of palmar aponeurosis plus free skin grafting on 10 hands. Results All cases were followed up for an average of 5 years, most cases were freed from contracture of palmar aponeurosis and recurrence was found only in 5 cases. Complications as nerve injury, subcutaneous hemorrhage, and partial necrosis of the grafted skin appeared on 15 hands. Conclusion Dupuytren's contracture is common in other countries, but relatively rare in China. In Chinese patients obvious contracture is usually found when patients come to clinic. Surgical treatment of Dupuytren's contracture is satisfactory and early operation is recommended.