title: Clinical outcomes of primary skin closure with Y-V and Z-plasties for Dupuytren's contracture: use of one-stage skin closure.
abstract: Y-V or Z-plasties are a useful one-stage technique for skin closure after aponeurotomy. However, we know no details about postoperative improvement, particularly at each joint. The purpose of this study was to evaluate the clinical outcomes of primary skin closure with Y-V and Z-plasties for Dupuytren's contracture. We retrospectively reviewed the postoperative results of 23 patients (25 hands, 29 fingers). The preoperative severity of the contracture evaluated by the Meyerding classification was grade I in 11 fingers, II in two fingers, and III in 16 fingers. In total, 26 metacarpophalangeal (MP) joints and 27 proximal interphalangeal (PIP) joints were treated. In each finger we assessed clinical outcomes according to the percentage improvement in extension and a modified version of Tubiana's classification. Primary wound closure was possible in all cases. The mean contracture values were improved from 46.5° preoperatively to 4.2° postoperatively for the MP joint and from 43.9° to 22.4° for the PIP joint. The mean percentage improvement in extension for the MP joint was 92% and for the PIP joint 56%. The rate for the PIP joint of the little finger was 40% and for the other fingers 78%. In total, 83% of the fingers had satisfactory results. For Dupuytren's contracture, primary skin closure with Y-V and Z-plasties gives satisfactory results, more so with involvement of the MP than the PIP joint and less so with involvement of the little finger.
authors: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan. t-uemura@med.osaka-cu.ac.jp
authors: Takuya
authors: T
authors: Uemura
authors: Kenichi
authors: K
authors: Kazuki
authors: Takeshi
authors: T
authors: Egi
authors: Masahiro
authors: M
authors: Yoneda
authors: Kiyohito
authors: K
authors: Takamatsu
authors: Hiroaki
authors: H
authors: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D062109:Dermatologic Surgical Procedures; D004387:Dupuytren Contracture / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005384:Finger Joint / Q000601:surgery; D006225:Hand / Q000601:surgery; D006227:Hand Deformities, Acquired / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013524:Surgical Flaps / Q000098:blood supply*; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*