掌腱膜挛缩症的手术治疗

目的 探讨掌腱膜挛缩症手术方法的改进,分析其疗效.方法 2008年9月至2009年8月,采用掌腱膜部分切除术治疗掌腱膜挛缩症患者9例11侧,对传统的治疗方法加以改进,以游离植皮的理念处理掌侧皮瓣.结果 本组患者术后切口均Ⅰ期愈合,无皮下血肿、皮缘坏死、切口感染等术后早期并发症发生.随访1～6个月,平均3.3个月,无一例复发.按中华医学会手外科学会上肢部分功能评定试用标准评定:患手运动功能优9例,良2例;优良率为100%.结论 在掌腱膜部分切除术中以游离植皮的理念处理掌侧皮肤可明显降低术后早期并发症.     

The surgical treatment of Dupuytren's contracture]

Treatment of 129 patients with palmar fibromatosis was performed; all the men were from 20 to 63 years old. In 56 patients (1st main group) operation of aponeurectomy was performed with the help of an ultrasonic scalpel (USS), in 53 patients (2nd main group) the operation was made with the help of the microsurgical technique (MST), 30 patients (a control group) were operated upon by usual methods. The use of USS and MST were followed by excellent (92.6%), good (2.1%) and satisfactory (5.3%) long-term results.     

Ambulatory surgical treatment of patients with Dupuytren's contracture

Experience in surgical treatment of 61 outpatients (64 hands) is discussed. The organization of treatment was accomplished stage-by-stage: stage I, detection, selection, examination, preoperative management, stage II, operation in an in-patient operating room, stage III, postoperative management of a patient. Postoperative complications in the form of partial necrosis of the edge of the wound developed in 3 patients. The late-term functional postoperative results were studied in 25 patients; they were good in 17 and satisfactory in 8 patients. Thus, high clinical efficacy was demonstrated in out-patient treatment of Dupuytren's++'s contracture by the method described.     

Salvage of severe recurrent Dupuytren's contracture of the ring and small fingers

Severe recurrent digital Dupuytren's contracture, with pseudomotor changes and inadequate palmar tissue, is often treated with amputation. In this study, 11 patients had 14 proximal interphalangeal joint fusions with shortening done for salvage of recurrent Dupuytren's rather than amputation. Indications for operation were pseudomotor changes, severe palmar fibrosis, previous operations, and a flexion contracture of greater than 70 degrees.