[Angiopasm and lesion of the ulnar nerve in Dupuytren's contracture (author's transl)].
30 patients with Dupuytren's contracture were investigated by venous occlusion plethysmography of the index and ring fingers of both hands. The results are evaluated in respect to the clinical and electroneurophysiological findings. Special attention was given to the blood flow disturbances which have plethysmographically appeared to be a significant feature of Dupuytren's contracture and also to ulnar nerve lesions in individual cases. The finger venous occlusion plethysmography technique of Goetz (1934) has been further developed and a suitable apparatus constructed for the purpose of these investigations. Temporary vasopasm occurs in 77% of the patients suffering from Dupuytren's contracture when the fingers are cooled to 15 degrees C and a significant diminution of blood flow, as in the Raynaud syndrome, is evident. These neurovascular changes always appeared on the fingers of both hands and were similarly found in the region of the median nerve and of the ulnar nerve. They did not depend on the localization or the stage of the disease. 68% of the patients had symptoms suggestive of an ulnar nerve lesion, which corresponds with the findings of Mumenthaler (1961). In a comparison of the patients with normal plethysmographical findings and the patients with vasospasm, there is no correlation with the accompanying ulnar lesion. It is, thus, suggested that temporary vasopasm is not a consequence of the ulnar nerve lesion, but is related to an independent constitutional factor. In view of the high incidence of the ulnar lesion in patients with Dupuytren's contracture, a special neurological investigation is recommended and appropriate therapy, in addition to the fasiectomy, must be undertaken.
D000328:Adult; D000368:Aged; D004387:Dupuytren Contracture / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology; D010992:Plethysmography, Impedance / Q000379:methods*; D014459:Ulnar Nerve; D014652:Vascular Diseases / Q000150:complications* / Q000175:diagnosis
Fingerplethysmographische untersuchungen zur pathogenese der dupuytrenschen kontraktur, angiospasmus und ulnarisläsion