Surgical management of dupuytren’s disease
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MAFTEI, Dumitru. Surgical management of dupuytren’s disease. In: MedEspera: International Medical Congress for Students and Young Doctors, Ed. 7th edition, 3-5 mai 2018, Chişinău. Chisinau, Republic of Moldova: 2018, 7, pp. 142-143.
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MedEspera
7, 2018
Congresul "International Medical Congress for Students and Young Doctors"
7th edition, Chişinău, Moldova, 3-5 mai 2018

Surgical management of dupuytren’s disease


Pag. 142-143

Maftei Dumitru
 
”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
 
Disponibil în IBN: 18 noiembrie 2020


Rezumat

Introduc tion. Dupuytren's disease (M 72.0) is a fibroproliferative disorder, a disease of the conjuctive system of unknown etiology, which often leads to shortening and thickening of the palmar and digital fascia, to a permanent and irreversible flexion of the fin gers. Dupuytren's contracture mainly affects the ring finger and pinky, and occurs most often in older men of Northern European descent. Aim of the study. The retrospective and prospective analysis of the surgical treatment results of MD through various su rgical methods. Materials and methods. During 2013 2017, in department of Hand Surgery with the application of microsurgical techniques in Clinical Hospital of Traumatology and Orthopedics, at 426 patients (361 (84.7%) men and 65 (15.2%) women) Dupuytren's disease was diagnosed and treated wit h different surgical techniques. The mean age for men was 57.3 years and for women 59.6 years, mean age for both 58.5 years. Urban patients 156 (36.7%), rural 270 (63.3%). The number of patients that had their right hand operated was 246 (57.7%) and the left hand 180 (42.3%). The most commonly affected finger was finger IV 129 patients (51.19%); finger V 92 patients (36.51%); III 22 (8.73%); I 8 (3.17%); II 1 (0.4%). III degree of Dupuytren disease was found in 343 (81%) patients, II degre e at 60 (14%) and IV degree in 23 (5.4%) patients. In most cases (289 patients) selective excision of palmar aponeurosis with Z plasty was performed; in 37 cases percutaneous needle aponeurotomy (PNA) was performed; in 13 patients the open palm technique (from Mc Cash 1964); in 12 patients cross finger skin flap; in 3 cases radial forearm flap and in 2 cases the amputation of pinky finger Results. In order to evaluate the patient's condition and the function of the pre and post operative upper limb the DASH subjective inquiry "Disability of the Arm, Shoulder and Hand Outcome Measure" was used. Conclusions. Regardless of the successes in the treatment of orthopedic diseases and experience in the treatment of the serious forms of Dupuytren diseas, the issue of the treatment of these patients remains current. Surgical treatment can correct contractions, but the issue of recurrences and enlargements of the disease remains unresolved.

Cuvinte-cheie
Dupuytren’s contracture, Dupuytren’s diseas, Dupuytren's diathesis