The Clinical Summary Of The Surgical Treatment Of Dupuytren's Contracture

Objective: Investigate the clinic results of different surgical treatment methods of Dupuytren's Contracture, to explore the best treatment.Method: With 35 cases accepting different surgical treatment were reviewed, these cases were treated in the Orthopedics Department of the Second Affiliated Hospital of Medical School Zhejiang University,Within Sep, 1990 to Dec, 2006. Data was collected from the medical records, telephone following-up and clinic rechecking.1.Collecting patient's age, gender, habit, health information, place of contracture, type of pathology, operation method, complications and recurrence.2.Sorting data through classifying the cases by age, gender, health information, place of contracture, type of pathology, operation method, then analyzing the recurrence rate and complication of different operations method.3. Comparing the recurrence rate and complication of different operation methods, find out which way is better.Result: Within 35 cases, male 32, female 3, the ratio of men to women is about 10:1. There are 52 hands, 14 hands were carried on by palmare fascia partial excision (4 Huang type III, 2 type IV),among them, 6 hands (4 type III,2 type IV)recurred, the rate was 42.86%. 38 hands were carried an by palmare fascia excision and skin transplantation(3 type III, 35 type IV),no hand recurred, but 5 cases relapsed in another fingers or the other hand. In all cases, 5 cases recurred among the 15 cases which have risk factors, as the rate 33.3%; 1 cases recurred among the 20 cases without risk factors recurred, as the rate 5%;There are significant difference between the two sets(P<0.05).All recurrence occurred in those suffered palmare fascia partial excision.Conclusion: 1.The surgical treatment of Dupuytren's Contracture can acquire satisfied result and effect, there were some recurrence in palmare fascia partial excision group with less complication. Today, these is no recurrence report in palmare fascia excision and skin transplantation group, while there were more and severer complications in this group.2. For the cases who have risk factors, such as hyperlipmia, insobriety and diabetes, palmare fascia excision and skin transplantation can prevent from recurring effectively, but not relapsing in the other fingers or another hand.