12例掌腱膜桡侧挛缩的临床诊疗与护理

Clinical Features and Treatment of Dupuytren’s Disease on Radial Part of the Hand Narsing

目的探讨掌腱膜桡侧挛缩的病变特点和临床疗效。方法对12例因掌腱膜桡侧挛缩行手术治疗的病例进行回顾性分析。12例的病变均位于虎口和大鱼际区域,表现为皮肤纠集、结节和条索,很少影响拇指的活动范围。均手术切除局部的掌腱膜条索。10例患者获得随访,平均随访24.6个月。结果掌腱膜桡侧挛缩多于尺侧挛缩并发,手术治疗总体疗效较好,仅有1例复发。结论掌腱膜桡侧挛缩的发病部位集中于第一掌指关节的掌侧、大鱼际尺侧、虎口部位和大鱼际桡侧,未见累及指间关节,手术治疗可取得良好效果。

Objective To explore the clinical features and clinical outcome of Dupuytren＇s disease on the radial part of the hand. Methods Twelve cases of Dupuytren＇s disease on the radial part of the hand were studied retrospectively. All of them were located on the first web space and thenar eminence region, demonstrating tangled skin, nods and cords. Range of motion of the thumb was slightly impacted. The local strip of palmar aponeurosis was excised. Ten cases were followed up with an average of 25.1 months.Results The contracture of the palmar aponeurosis in the radial part of the hand often occurred in combination with that in the ulnar side.The general results were satisfactory. Only 1 case recurred. The interphaleangeal joint was seldom involved. Conclusion The typical locations of Dupuytren＇s disease on the radial part are the first metarcarpophalangeal joint at the palmar side, the thenar eminence at the ulnar side, the first web space and the thenar eminence at the radial side. The interphalangeal joint is rarely affected. Good results can be achieved after aponeurectomy.