281例晚期Dupuytren病皮筋膜切除术疗效的20年纵向分析

IF 2.1 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2025-06-01 DOI:10.1016/j.jhsa.2025.02.007

Wg Cdr Ankur Pandya Eur Dip Hand Surg, FRCS(Plast) , Dujanah Bhatti MRCS , Oliver Manley MRCS

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引用次数: 0

摘要

目的：本研究旨在评估20年来晚期Dupuytren病患者皮筋膜切除术的长期疗效和结果。方法：对281例经皮筋膜切除术治疗的晚期Dupuytren病患者进行纵向分析。系统记录和分析疾病严重程度、手术技术、近端指间关节挛缩复发率、疾病复发、伤口并发症和术后护理方案。结果：共回顾了281例病例，其中患者因晚期Dupuytren病接受了皮筋膜切除术。全层植皮丢失的病例占1.1%，部分丢失的病例占4.2%，主要发生在糖尿病患者。3.1%的病例观察到交界区复发，移植物下无复发。功能结果良好，97%的患者报告手功能改善。神经损伤最小，2.8%为短暂性神经失用症，只有一例（0.4%）为持续性感觉丧失。结论：皮筋膜切除术似乎是晚期Dupuytren病的一种非常有效的手术干预，在功能和疾病控制方面提供了实质性的长期益处。这些发现强调了皮筋膜切除术治疗晚期病例的有效性和持久性，特别是适当的术后护理。研究类型/证据水平：治疗性IIb。

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A Longitudinal Analysis of 281 Cases of Dermofasciectomy Efficacy in Advanced Dupuytren Disease Cases: A 20-Year Perspective

Purpose

This study aimed to evaluate the long-term efficacy and outcomes of dermofasciectomy in patients with advanced Dupuytren disease over a 20-year period.

Methods

A longitudinal analysis was conducted on 281 cases of advanced Dupuytren disease treated with dermofasciectomy. Disease severity, surgical techniques, rates of proximal interphalangeal joint contracture recurrences, disease recurrence, wound complications, and postoperative care protocols were systematically recorded and analyzed.

Results

A total of 281 cases were reviewed, with patients undergoing dermofasciectomy for advanced Dupuytren disease. Full-thickness skin graft loss occurred in 1.1% of cases, with partial loss in 4.2%, primarily in diabetic patients. Junctional recurrence was observed in 3.1% of cases, with no recurrence under the graft itself. Functional outcomes were favorable, with 97% of patients reporting improved hand function. Nerve damage was minimal, with transient neuropraxia in 2.8% and only one case (0.4%) of persistent sensory loss.

Conclusions

Dermofasciectomy appears to be a highly effective surgical intervention for advanced Dupuytren disease, offering substantial long-term benefits in terms of function and disease control. These findings underscore the efficacy and durability of dermofasciectomy in managing advanced cases, particularly with appropriate postoperative care.

Type of study/level of evidence

Therapeutic IIb.

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.