Abstract
A 69-year-old female, right-hand dominant, presented with recurrent bilateral Dupuytren’s contractures requiring multiple limited fasciectomy. His last surgery involved a limited fasciectomy of small and ring finger with application of Digit-widget™ (Hand Biomechanics Lab, Sacramento, CA) device for correction of a long-standing flexion contracture (Fig. 16.1). Her preoperative radiographs demonstrated some evidence of proximal interphalangeal (PIP) joint arthritic changes; however as per patients request, an attempt to preserve the joint was elected. Following the surgical subtotal fasciectomy and application of Digit-widget™ the flexion contracture was corrected to 25°. Within 2 months, she had a rapid recurrence of flexion deformity (Fig. 16.2). Thus a decision was made to proceed with an attempt of Xiaflex® (Auxilium, Chesterbrook, PA) injection. Minimal improvement was noted after the release and a decision to proceed with salvage procedure and PIP joint arthrodesis to address both the Boutonnière deformity and the flexion contracture recurrence.
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References
Gordon S. Dupuytren’s contracture: recurrence and extension following surgical treatment. Br J Plast Surg. 1957;9(4):286–8.
Hueston JT. Digital Wolfe grafts in recurrent Dupuytren’s contracture. Plast Reconstr Surg Transplant Bull. 1962;29:342–4.
Roush TF, Stern PJ. Results following surgery for recurrent Dupuytren’s disease. J Hand Surg. 2000;25(2):291–6.
Tonkin MA, Burke FD, Varian JP. Dupuytren’s contracture: a comparative study of fasciectomy and dermofasciectomy in one hundred patients. J Hand Surg. 1984;9(2):156–62.
Watson HK, Fong D. Dystrophy, recurrence, and salvage procedures in Dupuytren’s contracture. Hand Clin. 1991;7(4):745–55. discussion 757–8.
Moberg E. Three useful ways to avoid amputation in advanced Dupuytren’s contracture. Orthop Clin North Am. 1973;4(4):1001–5.
Beyermann K, Jacobs C, Lanz U. Severe contractures of the proximal interphalangeal Joint in Dupuytren’s disease: value of capsuloligamentous release. Hand Surg. 1999;4(1):57–61.
Rives K, et al. Severe contractures of the proximal interphalangeal joint in Dupuytren’s disease: results of a prospective trial of operative correction and dynamic extension splinting. J Hand Surg. 1992;17(6):1153–9.
Tonkin MA, Burke FD, Varian JP. The proximal interphalangeal joint in Dupuytren’s disease. J Hand Surg. 1985;10(3):358–64.
Vigroux JP, Valentin P. A natural history of Dupuytren’s contracture treated by surgical fasciectomy: the influence of diathesis (76 hands reviewed at more than 10 years). Ann Chir Main Memb Super. 1992;11(5):367–74.
Suggested Readings
Watson HK, Fong D. Dystrophy, recurrence, and salvage procedures in Dupuytren’s contracture. Hand Clin. 1991;7(4):745–55. discussion 757–8.
Wolfe SW, Pederson WC, Hotchkiss RN, Kozin SH. Green’s operative hand surgery: 2-volume set. 6th ed. Philadelphia: Churchill Livingstone; 2010.
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Izadpanah, A., Rizzo, M. (2016). Arthrodesis in Treatment of Dupuytren’s Contracture. In: Rizzo, M. (eds) Dupuytren’s Contracture. Springer, Cham. https://doi.org/10.1007/978-3-319-23841-8_16
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DOI: https://doi.org/10.1007/978-3-319-23841-8_16
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