Does a 'firebreak' full-thickness skin graft prevent recurrence after surgery for Dupuytren's contracture?: a prospective, randomised trial.
We randomised 79 patients (84 hands, 90 fingers) with Dupuytren's contracture of the proximal interphalangeal joint to have either a 'firebreak' skin graft (39 patients, 41 hands, 44 fingers) or a fasciectomy (40 patients, 43 hands, 46 fingers) if, after full correction, the skin over the proximal phalanx could be easily closed by a Z-plasty. Patients were reviewed after three, six, 12, 24 and 36 months to note any complications, the range of movement and recurrence. Both groups were similar in regard to age, gender and factors considered to influence the outcome such as bilateral disease, family history, the presence of diabetes, smoking and alcohol intake. The degree of contracture of the metacarpophalangeal and interphalangeal joints of the operated fingers was similar in the two groups and both were comparable in terms of grip strength, range of movement and disability at each follow-up. The recurrence rate was 12.2%. We did not identify any improvement in correction or recurrence of contracture after firebreak dermofasciectomy up to three years after surgery.
Ullah
A S
AS
Department of Orthopaedic Surgery, University Hospitals of Leicester NHS Trust, Groby Road, Leicester LE3 9QP, UK.
Dias
J J
JJ
Bhowal
B
B
D000368:Aged; D004387:Dupuytren Contracture / Q000517:prevention & control / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005384:Finger Joint / Q000503:physiopathology / Q000601:surgery; D018737:Hand Strength; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D055502:Secondary Prevention; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome