Review of Partial Fasciectomy for Dupuytren's Contracture in Southern Chinese Patients

摘要

Dupuytren's contracture is a fibroproliferative disease of the palmar fascia producing fascial fibrosis in nodular or cord form, and results in flexion contracture of the involved fingers. In contrast to Western populations, Dupuytren's contracture, especially the severe form of the disease, is not common in Southern Chinese patients: there have been only scant reports from the Southern Chinese region. In addition, the natural history and surgical outcome may be different from those of Western patients. The purpose of our study was to evaluate the clinical outcomes of Southern Chinese patients with Dupuytren's contracture treated with partial fasciectomy through a Bruner's incision. Twenty-nine Chinese patients (45 fingers) with Dupuytren's contracture were reviewed retrospectively from 1999 to 2008. All patients underwent partial fasciectomy performed under general anaesthesia. The ranges of movement of the metacarpophalangeal (MCPJ) and proximal interphalangeal (PIPJ) joints were measured preoperatively and during follow-up to assess the degree of correction after surgery. A total of 34 out of 45 fingers (75.6%) and 30 out of 45 fingers (66.7%) had regained a full range of movement of the MCPJs and PIPJs, respectively. In addition, 26 out of 29 patients (89.6%) had an improvement in extension of their MCPJs, and 20 out of 29 patients (68.9%) showed a gain in extension of their PIPJs. One in 29 patients (3.4%) developed a wound infection and needed further surgery for debridement. One patient had recurrent PIPJ contracture after partial fasciectomy (3.4%). None of our patients had a neurovascular injury or wound healing problem. We conclude that partial fasciectomy with a Bruner's incision yields satisfactory results in Southern Chinese patients that are comparable to results from Western studies.