title: [Supplementary arthrolysis of the proximal interphalangeal joint of fingers in surgical treatment of Dupuytren's contracture].
abstract: OBJECTIVE
  Correction of residual flexion deformity of the proximal interphalangeal (PIP) joint after excision of diseased connective tissue in Dupuytren's contracture by stepwise arthrolysis.
  
  
  METHODS
  Flexion deformity of the PIP joint of 20° or more after excision of the diseased connective tissue in Dupuytren's contracture.
  
  
  METHODS
  Joint deformities, osteoarthrosis, intrinsic muscle contracture, instability of the PIP joint.
  
  
  METHODS
  Arthrolysis of the PIP joint is performed by six consecutive steps: dissection of the remaining skin ligaments, opening the flexor tendon sheath by transverse incision at the distal end of the A2 pulley, dissection of the checkrein ligaments, dissection of the accessory collateral ligaments, releasing the palmar plate proximally, releasing the palmar plate up to its insertion at the middle phalanx base.
  
  
  METHODS
  Dorsal plaster of Paris with extended fingers and compressive dressing in the palm for 2 days, occupational/physical therapy, static and possible dynamic extension splint several weeks/months.
  
  
  RESULTS
  A total of 31 fingers in 28 patients with Dupuytren's contracture were evaluated an average of 22 months after arthrolysis of the PIP joint. In all, 26 joints with an average recurrent flexion contracture of 29° were improved compared to the preoperative flexion contracture of 81°; 4 PIP joints with a recurrent flexion contracture averaging 60° were worse. In one patient, PIP flexion contracture of 90° was unchanged at follow-up although the joint could be extended intraoperatively to 10° of flexion.
authors.affiliation: Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Bremervörder Strasse 111, 21682, Stade, Deutschland. bernd.hohendorff@hotmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Hohendorff
authors.affiliation: Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Bremervörder Strasse 111, 21682, Stade, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Biber
authors.affiliation: Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Bremervörder Strasse 111, 21682, Stade, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Sauer
authors.affiliation: Unfall-, Hand- und Ellenbogenchirurgie, Universitätsklinikum zu Köln, Köln, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Ries
authors.affiliation: Handchirurgie, Vulpius Klinik, Bad Rappenau, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Spies
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Elbe Klinikum Stade, Stade, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Franke
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods*; D004387:Dupuytren Contracture / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D006801:Humans; D057913:Joint Capsule Release / Q000379:methods*; D008297:Male; D016059:Range of Motion, Articular; D016896:Treatment Outcome
keywords: Dupuytren’s disease; Finger joint; Hand deformities; Interphalangeal joint of finger; Muscle diseases