title: Supplementary arthrolysis of the proximal interphalangeal finger joint in Dupuytren's contracture: primary operation versus revision.
abstract: BACKGROUND
  In operative treatment of Dupuytren's disease, in certain cases proximal interphalangeal joint (PIP) flexion contracture remains after fasciectomy which can be corrected by a supplementary arthrolysis, but few data comparing primary and revision surgery are available.
  
  
  METHODS
  Fifteen patients who had a fasciectomy and supplementary PIP arthrolysis at the affected finger for the first time were compared to 13 patients who had a revision fasciectomy with a supplementary PIP arthrolysis. Upon follow-up at 22 months, flexion contracture was measured and data were compared to the preoperative values. Patient satisfaction with the outcome of the operation was determined and patients completed the Disabilities of the Arm, Shoulder and Hand outcome measure questionnaire.
  
  
  RESULTS
  Fingers of patients with Dupuytren's disease that had a partial fasciectomy and supplementary arthrolysis of the PIP for the first time had a median residual PIP flexion contracture of 30° compared 39° of fingers that had a partial fasciectomy and supplementary arthrolysis of the PIP as a revision. The patients of both groups were equally satisfied with the outcome of the operation, while their DASH scores were nearly identical.
  
  
  CONCLUSIONS
  After a mean follow-up of 2 years, the outcome of recurrent PIP contracture is comparable in patients with Dupuytren's disease that were treated by partial fasciectomy and supplementary arthrolysis for the first time and as a revision.
authors.affiliation: Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Bremervörder Strasse 111, 21682, Stade, Germany. bernd.hohendorff@hotmail.com.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hohendorff
authors.affiliation: Handchirurgie, Vulpius Klinik, Bad Rappenau, Germany.
authors.forename: C K
authors.initials: CK
authors.lastname: Spies
authors.affiliation: Unfall-, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum zu Köln, Cologne, Germany.
authors.forename: L P
authors.initials: LP
authors.lastname: Müller
authors.affiliation: Unfall-, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum zu Köln, Cologne, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Ries
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004387:Dupuytren Contracture / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D000267:Tissue Adhesions / Q000601:surgery*; D016896:Treatment Outcome
keywords: Arthrolysis; Capsuloligamentous release; Dupuytren’s disease; Fasciectomy; Proximal interphalangeal joint