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Multiple Recurrences in Aggressive Forms of Dupuytren’s Disease—Can Patients Benefit from Repeated Selective Fasciectomy?

BACKGROUND: In Dupuytren’s disease (DD), limited fasciectomy is the mainstay of surgical therapy in patients at risk of contractures and disease recurrences. New minimally invasive treatments such as injection of collagenase clostridium histolyticum have evolved as a common tool for the preliminary...

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Autores principales: Könneker, Sören, Broelsch, G. Felix, Krezdorn, Nicco, Dastagir, Khaled, Kuhbier, Jörn W., Paprottka, Felix J., Vogt, Peter M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340496/
https://www.ncbi.nlm.nih.gov/pubmed/28280681
http://dx.doi.org/10.1097/GOX.0000000000001247
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author Könneker, Sören
Broelsch, G. Felix
Krezdorn, Nicco
Dastagir, Khaled
Kuhbier, Jörn W.
Paprottka, Felix J.
Vogt, Peter M.
author_facet Könneker, Sören
Broelsch, G. Felix
Krezdorn, Nicco
Dastagir, Khaled
Kuhbier, Jörn W.
Paprottka, Felix J.
Vogt, Peter M.
author_sort Könneker, Sören
collection PubMed
description BACKGROUND: In Dupuytren’s disease (DD), limited fasciectomy is the mainstay of surgical therapy in patients at risk of contractures and disease recurrences. New minimally invasive treatments such as injection of collagenase clostridium histolyticum have evolved as a common tool for the preliminary treatment of Dupuytren’s contractures. However, recurrences and their therapy remain controversial. In this study, we evaluate the benefit of repeated limited fasciectomy in patients with aggressive forms of the disease and multiple recurrences of contractures. METHODS: We evaluated the outcome of 16 patients undergoing limited fasciectomy 3 or more times on a single hand. RESULTS: Postoperatively, 10 of 13 (76.9%) patients were satisfied with the clinical result after the last operation; 10 of 12 (83.3%) patients would choose to have their surgery repeated, if so needed. The mean improvement of proximal interphalangeal joint range of motion was 59.2 degrees (SD 26.8) and 86.2% (SD 19.9). There were no severe complications after treatment within the observed time period. CONCLUSIONS: Our findings demonstrate that patients with recurrence of contractures after multiple previous treatments in aggressive forms of DD can benefit from surgical intervention. In conclusion, repeated limited fasciectomy remains indicated in patients after previous surgeries with DD.
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spelling pubmed-53404962017-03-09 Multiple Recurrences in Aggressive Forms of Dupuytren’s Disease—Can Patients Benefit from Repeated Selective Fasciectomy? Könneker, Sören Broelsch, G. Felix Krezdorn, Nicco Dastagir, Khaled Kuhbier, Jörn W. Paprottka, Felix J. Vogt, Peter M. Plast Reconstr Surg Glob Open Original Article BACKGROUND: In Dupuytren’s disease (DD), limited fasciectomy is the mainstay of surgical therapy in patients at risk of contractures and disease recurrences. New minimally invasive treatments such as injection of collagenase clostridium histolyticum have evolved as a common tool for the preliminary treatment of Dupuytren’s contractures. However, recurrences and their therapy remain controversial. In this study, we evaluate the benefit of repeated limited fasciectomy in patients with aggressive forms of the disease and multiple recurrences of contractures. METHODS: We evaluated the outcome of 16 patients undergoing limited fasciectomy 3 or more times on a single hand. RESULTS: Postoperatively, 10 of 13 (76.9%) patients were satisfied with the clinical result after the last operation; 10 of 12 (83.3%) patients would choose to have their surgery repeated, if so needed. The mean improvement of proximal interphalangeal joint range of motion was 59.2 degrees (SD 26.8) and 86.2% (SD 19.9). There were no severe complications after treatment within the observed time period. CONCLUSIONS: Our findings demonstrate that patients with recurrence of contractures after multiple previous treatments in aggressive forms of DD can benefit from surgical intervention. In conclusion, repeated limited fasciectomy remains indicated in patients after previous surgeries with DD. Wolters Kluwer Health 2017-02-23 /pmc/articles/PMC5340496/ /pubmed/28280681 http://dx.doi.org/10.1097/GOX.0000000000001247 Text en Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Article
Könneker, Sören
Broelsch, G. Felix
Krezdorn, Nicco
Dastagir, Khaled
Kuhbier, Jörn W.
Paprottka, Felix J.
Vogt, Peter M.
Multiple Recurrences in Aggressive Forms of Dupuytren’s Disease—Can Patients Benefit from Repeated Selective Fasciectomy?
title Multiple Recurrences in Aggressive Forms of Dupuytren’s Disease—Can Patients Benefit from Repeated Selective Fasciectomy?
title_full Multiple Recurrences in Aggressive Forms of Dupuytren’s Disease—Can Patients Benefit from Repeated Selective Fasciectomy?
title_fullStr Multiple Recurrences in Aggressive Forms of Dupuytren’s Disease—Can Patients Benefit from Repeated Selective Fasciectomy?
title_full_unstemmed Multiple Recurrences in Aggressive Forms of Dupuytren’s Disease—Can Patients Benefit from Repeated Selective Fasciectomy?
title_short Multiple Recurrences in Aggressive Forms of Dupuytren’s Disease—Can Patients Benefit from Repeated Selective Fasciectomy?
title_sort multiple recurrences in aggressive forms of dupuytren’s disease—can patients benefit from repeated selective fasciectomy?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340496/
https://www.ncbi.nlm.nih.gov/pubmed/28280681
http://dx.doi.org/10.1097/GOX.0000000000001247
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