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.
Dupuytren contracture
distracted driving
joint dislocation
Journal
Journal of personalized medicine
ISSN: 2075-4426
Titre abrégé: J Pers Med
Pays: Switzerland
ID NLM: 101602269
Informations de publication
Date de publication:
01 Mar 2022
01 Mar 2022
Historique:
received:
07
02
2022
revised:
25
02
2022
accepted:
26
02
2022
entrez:
25
3
2022
pubmed:
26
3
2022
medline:
26
3
2022
Statut:
epublish
Résumé
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. 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. 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%). 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 35330378
pii: jpm12030378
doi: 10.3390/jpm12030378
pmc: PMC8953560
pii:
doi:
Types de publication
Journal Article
Langues
eng
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