[Treatment of recurrent Dupuytren's disease].
BACKGROUND
The tendency of recurrence or progression is a frequent problem in Dupuytren's disease. The management of recurrence is adapted to the individual situation and the patient's needs. In mild cases a non-operative approach is recommended. Revision surgery is reserved for disabling situations with acceptable circulation and sensation in absence of dystrophy. It is complicated by a combined formation of scar tissue and new cords. This increases the risk of soft tissue loss and injuries to the neurovascular bundles, which impair sensation and circulation and may result in loss of the finger.


METHODS
The strategy consists of preoperative planning of the soft tissue reconstruction, meticulous preparation of the neurovascular bundles, arthrolyses and skin closure by Z‑plasty or transposition flaps. The corrective arthrodesis of the proximal interphalangeal joint may be an alternative to improve function without the risks of revision surgery. In cases of severe impaired circulation, sensation or dystrophy of the finger, amputation or ray resection may be indicated.
Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland. t.pillukat@handchirurgie.de.
T
T
Pillukat
Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland.
L
L
Walle
Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland.
R
R
Stüber
Klinik für Unfall- und Handchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland.
J
J
Windolf
Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland.
J
J
van Schoonhoven
D001174:Arthrodesis / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D004387:Dupuytren Contracture / Q000517:prevention & control* / Q000601:surgery*; D019317:Evidence-Based Medicine; D000071938:Fasciotomy / Q000379:methods*; D006225:Hand / Q000601:surgery*; D006801:Humans; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D055502:Secondary Prevention / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome
Arthrodesis; Fibromatosis, palmar; Recrudescence; Revision, surgical; Surgical flap