Clinical Results of Percutaneous Needle Fasciotomy for Dupuytren’s Disease in Japanese Patients
نویسندگان
چکیده
BACKGROUND Clinical results of percutaneous needle fasciotomy (PNF) in Japanese patients with Dupuytren's disease are reported. METHODS In this prospective study, 51 patients (103 fingers: 1 index, 9 middle, 47 ring, and 46 small) underwent PNF at 99 metacarpophalangeal (MCP) and 68 proximal interphalangeal (PIP) joints. Patients were assessed postoperatively after 1 day, at 1, 2, 4, 6, and 8 weeks, and at 3, 6, 9, and 12 months. Correction of contracture was measured in degrees, and an improvement index (% improvement) was described previously by Tonkin et al. A correction of the contracture to 5° or less at each joint and at each digital ray represented a successful correction. The recurrence rates in MCP and PIP joints were also evaluated. Correlations between the Tubiana classification stage and successful correction, % improvement, and recurrence rate were evaluated. The relationships between recurrence rate and the diathesis score (more/less than 5 points) and between recurrence rate and age at surgery (<50/≥50 years) were also examined. RESULTS In MCP and PIP joints, the improvement maintained at final follow-up was 89% and 57%, respectively, with successful corrections in 89% and 76%, respectively. PNF corrected digital rays at various Tubiana stages: stage 1 = 100%, stage 2 = 82%, stage 3 = 46%, and stage 4 = 0%. Improvements were preserved in stage 1 = 83%; stage 2 = 62%; stage 3 = 58%, and stage 4 = 60%. Recurrence of Dupuytren's disease was significant for the PIP joint, severe Tubiana stage, and younger patients. CONCLUSIONS Clinical results of PNF in Japanese patients with Dupuytren's contractures were similar to those of whites.
منابع مشابه
Surgical treatment for Dupuytren’s disease: open fasciotomy and fasciectomy
The traditional role of surgery in the treatment of Dupuytren’s disease is being challenged by less invasive treatment options, specifically percutaneous needle fasciotomy and, more recently, collagenase injection. Nonetheless, surgery maintains an important place in the management of this condition. For many surgeons and in many situations, for example multiple digit involvement, recurrent dis...
متن کاملThe Re-Emergence of Percutaneous Fasciotomy in the Management of Dupuytren’s Disease
Dupuytren's disease is a common condition. Its management has gradually evolved but still remains a source of much controversy. Recently there has been a resurgence in the popularity of percutaneous needle fasciotomy. It is a simple method that uses a hypodermic needle as a scalpel blade. It is usually performed in the out-patient setting under local anaesthesia without a tourniquet. It has few...
متن کاملCurrent trends in the surgical management of Dupuytren’s disease in Europe: the surgeon’s perspective
INTRODUCTION: Dupuytren's disease (DD), commonly affecting European men, is generally treated with surgery. METHODS: Orthopaedic and plastic surgeons who had been practicing for >3 and <30 years and operated on ≥5 patients with DD between September and December 2008 were surveyed in 12 European countries (Czech Republic, Denmark, Finland, France, Germany, Hungary, Italy, The Netherlands, Polan...
متن کاملUltrasound-Assisted Percutaneous Needle Fasciotomy for Dupuytren's Contracture.
Although percutaneous needle fasciotomy for Dupuytren's contracture is a simple, inexpensive procedure, it is a blind procedure with risks including injury to nerves, arteries, and tendons. The authors describe a novel technique using ultrasound as an adjunct to percutaneous fasciotomy for Dupuytren's contracture. Generally, patients have no postoperative restrictions other than to avoid submer...
متن کاملDupuytrEn Treatment EffeCtiveness Trial (DETECT): a protocol for prospective, randomised, controlled, outcome assessor-blinded, three-armed parallel 1:1:1, multicentre trial comparing the effectiveness and cost of collagenase clostridium histolyticum, percutaneous needle fasciotomy and limited fasciectomy as short-term and long-term treatment strategies in Dupuytren’s contracture
INTRODUCTION Dupuytren's contracture (DC) is a chronic fibroproliferative disorder of the palmar fascia which leads to flexion contracture in one or more fingers. There is no definitive cure for DC, and treatment aims at relieving symptoms by releasing the contracture using percutaneous or operative techniques. METHODS AND ANALYSIS We planned a prospective, randomised, controlled, outcome ass...
متن کامل