[Minimally invasive treatment of Dupuytren's contracture by Pi needle percutaneous multi-segmental fasciotomy].
摘要
OBJECTIVE: To investigate the clinical efficacy of Pi needle percutaneous multi-segmental fasciotomy as a minimally invasive treatment for Dupuytren's contracture. METHODS: Sixteen patients(25 fingers: 4 middle fingers, 12 ring fingers, 9 little fingers) were involved in the study, including 11 males and 5 females. There were 2 cases on both hands and 14 cases of single hand disease, including 8 cases of left hand and 6 cases of right hand. The age ranged from 48 to 79 years old, with a mean age of 58.5 years old. The duration of the disease ranged from 1 to 15 years, with a mean time of 5.5 years. There were 12 cases of physical labor, 4 cases of non physical labor, with no family history of palmar fascial contracture. There were 9 cases of tobacco and alcohol addicts, 6 cases with hypertension history, and 3 cases of diabetes mellitus. According to Meyerding classification, 1 case was stage 0, 1 case was stage I, 10 cases were stage II, 4 cases were stage III and 0 case was stage IV. The postoperative function of Dupuytren's contracture patients was evaluated according to Adam efficacy evaluation criteria. RESULTS: The time of incision healing time ranged from 7 to 14 days, 10 days on average. The 3 fingers incision skin cracked 3 to 4 mm during the loosening process, and 14 days after dressing changed, no skin necrosis and wound infection complication occurred. After treatment, fascia contracture of 24 fingers completely or almost disappeared. Limited extension of metacarpophalangeal joint and interphalangeal joint ranged from 0 to 10 degrees, 22 fingers showed normal function of finger extension, 2 fingers had more than 75% elongation function, and 1 finger recurred. According to the evaluation of Adam evaluable standard of curative effect on the postoperative function of Dupuytrens's contracture: 22 fingers got an excellent result, 2 fingers good and 1 finger recurred. The patients were satisfied with the results of the treatment. CONCLUSIONS: Pi needle percuta