[Operative treatment of Dupuytren's contracture : Arthrolysis of the proximal interphalangeal finger joint].
BACKGROUND
In the operative treatment of Dupuytren's disease, in certain cases proximal interphalangeal joint flexion contracture remains after fasciectomy due to shrinkage, shortening, and/or adhesion of the periarticular structures.


OBJECTIVE
How can a residual flexion contracture of the proximal interphalangeal joint after partial fasciectomy in Dupuytren's disease be treated surgically and what follow-up results can be expected?


METHODS
Description of anatomy, indication, surgical technique of arthrolysis of the proximal interphalangeal joint, postoperative treatment, and critical analysis of the results reported in the literature.


RESULTS
Arthrolysis of the proximal interphalangeal joint is performed in up to six consecutive steps. An improvement of only about 50% compared to preoperative flexion contracture can be expected.


CONCLUSIONS
Despite alleged unsatisfactory results arthrolysis of the proximal interphalangeal joint can be recommended in surgery of Dupuytren's disease. In certain cases, patient cooperation during lengthy postoperative treatment is necessary.
Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Bremervörder Straße 111, 21682, Stade, Deutschland. bernd.hohendorff@hotmail.com.
B
B
Hohendorff
Klinik für Unfallchirurgie und Orthopädie, Elbe Klinikum Stade, Stade, Deutschland.
J
J
Franke
Handchirurgie, Vulpius Klinik, Bad Rappenau, Deutschland.
C K
CK
Spies
Handchirurgie, Vulpius Klinik, Bad Rappenau, Deutschland.
F
F
Unglaub
Unfall-, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum zu Köln, Köln, Deutschland.
L P
LP
Müller
Unfall-, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum zu Köln, Köln, Deutschland.
C
C
Ries
D004387:Dupuytren Contracture / Q000473:pathology* / Q000601:surgery*; D019317:Evidence-Based Medicine; D000071938:Fasciotomy / Q000379:methods*; D005384:Finger Joint / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D000267:Tissue Adhesions / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
Arthrolysis; Capsuloligamentous release; Dupuytren’s disease; Hand; Proximal interphalangeal finger joint