掌腱膜挛缩症50例报告

Dupuytren's contracture: A report of 50 cases

目的讨论掌腱膜挛缩症的病因，病变特点及治疗方法。方法总结和分析经手术治疗的掌腱膜挛缩症５０例７８只手。其中包括取掌腱膜作病理检查的１１例。行掌腱膜大部切除、手掌及手指挛缩皮肤“Ｚ”成形术６３只手，掌腱膜及受累皮肤一并切除后行游离植皮术１５只手。结果术后平均随访６．４年，见挛缩解除，疗效肯定，无１例复发。１４只手产生并发症如神经损伤、皮下血肿、皮片成活不良及伤口Ⅱ期愈合等占１７．８％。组织学检查结果：均为致密结缔组织增生。结论掌腱膜挛缩症国人报道较少，常发生于中、老年，男性居多，手术治疗效果肯定。为减少并发症的发生。

Objective To discuss the pathogenesis and treatment of Dupuytren's contracture. Methods 78 hands of 50 cases of Dupuytren's contracture were studied. All received surgical treatment, and pathological examination of palmar aponeurosis was performed in 11 cases . Excision of a majority of palmar aponeurosis plus Z shape skin plasty was undergone on 63 hands, and resection of palmar aponeurosis plus free skin grafting on 15 hands. All cases were followed up for an average of 6.4 years. Results All cases were freed from contracture of palmar aponeurosis, with no recurrence. Such complications as nerve injuries, subcutaneous hemorrhage or secondary healing appeared on 14 hands (17.8%). Histological examination showed hyperplasia of thick connective tissue. Conclusions Surgical treatment outcome of Dupuytren's contracture is satisfactory and early operation is recommended to reduce complication once flexus constraction with dysfunction is observed.