[Does digital percutaneous fasciotomy in Dupuytren's contracture provokes collateral nerves injuries? 25 cases].
It is well known that percutaneous fasciotomy must not be realized at the digital level because of the risks of iatrogenic nervous injury. The purpose of this study is to verify if the percutaneous fasciotomy in the digital level is responsible or not for sensory complication by injury of the collateral nerves, thanks to the precise sensory analysis of a series of twenty five palmodigital or digital fasciotomies. Our series included 20 patients operated on between September 2006 and June 2008, as a total of 25 fingers. Only one patient presented preoperative sensory disorders. It was a multi-operated finger. The patients were operated on in one-day surgery by two senior surgeons using percutaneous fasciotomy in the palm and the digit. The analysis of the results consisted in studying at follow-up pain, DASH score, and discriminative sensibility by the static test of Weber, and the test of mono strands of Semmes Weinstein. The postoperative average follow-up was of 10 months. The pain was on average 1.8/10 and the DASH score of 19.77/100. The statistical analysis of the discriminative sensibility showed that there was no significant difference in the average of the results between the hemi-pulp of the operated finger and that of the not operated finger (test of Weber 0.1 < p < 0.5; test of Semmes Weinstein 0.5 < p < 1). A single patient had a bad result at the same time in the Weber and in the Semmes Weinstein. It was a patient operated on several times. Our study shows that the digital percutaneous fasciotomy provokes no sensory disorder. Consequently, it is possible to spread the indications of percutaneous fasciotomy to Dupuytren's contracture in the digital region.
Ganeval
A
A
SOS Main Illkirch, CCOM, Hôpitaux Universitaires de Strasbourg, 10 Avenue Baumann, 67403 Illkirch Cedex, France.
Blancher
M-C
MC
Gouzou
S
S
Liverneaux
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062109:Dermatologic Surgical Procedures; D004387:Dupuytren Contracture / Q000150:complications* / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005385:Fingers / Q000294:innervation* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059348:Peripheral Nerve Injuries; D014947:Wounds and Injuries / Q000209:etiology*