小切口掌腱膜切除术治疗掌腱膜挛缩症的疗效分析

Fasciectomy with minimal incisions for treatment of Dupuytren's contracture

  • 摘要: 目的 探讨小切口掌腱膜切除术治疗掌腱膜挛缩症的疗效。方法 回顾性分析保定市第一中心医院2011年7月-2019年8月收治的掌腱膜挛缩症患者12例(15侧)。男性8例,女性4例,年龄17 ~ 72岁,中位年龄39岁。于腕部掌侧正中纵行切开一小切口,由此切口应用肌腱探子沿病变掌腱膜纵束向远处钝性分离,将掌腱膜与周围组织完全分离后予以切除,从而解除患指挛缩。采用中华医学会手外科学会上肢部分功能评定试用标准评定手功能恢复情况。结果 12例患者(15侧)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。随访时间平均12.5个月,无复发。功能评估:患手运动功能优13例,良2例;优良率为100%。结论 使用小切口掌腱膜切除术治疗掌腱膜挛缩症可缩短病程,减少术后早期并发症。

     

    Abstract: Objective To investigate the effect of fasciectomy with minimal incisions on the treatment of Dupuytren's contracture. Methods A total of 12 patients (15 hands) with Dupuytren's contracture admitted to No.1 Central Hospital of Baoding City from July 2011 to August 2019 were included in our study.There were 8 males and 4 females with age ranged from 17 to 72 (median age of 39) years.A median longitudinal incision was made at the palmar side of the wrist,from which the tendon probe was inserted to separate the palmar aponeurosis along the longitudinal bundle of the diseased palmar aponeurosis to the distance.After the palmar aponeurosis was completely separated from the surrounding tissue,it was resected so as to relieve the contracture of the affected finger. Results Primaryhealing was achieved in all incisions,and there was no early complication,such as subcutaneous hematoma,necrosis of skin margin and infection of incision.The average follow-up time was 12.5 months,and no recurrence was found.According to the evaluation standard of upper limb function developed by Hand Surgery branch of Chinese Medical Association,13 cases were assessed as excellent,2 cases were good,and the excellent and good rate was 100%. Conclusion Fasciectomy with minimal incisions has good effect with quick recovery and less early postoperative complications.

     

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