掌腱膜挛缩症的手术治疗

ThesurgiealtreatmentofDupuytren＇scontracture

目的探讨掌腱膜挛缩症手术方法的改进，分析其疗效。方法2008年9月至2009年8月，采用掌腱膜部分切除术治疗掌腱膜挛缩症患者9例11侧，对传统的治疗方法加以改进，以游离植皮的理念处理掌侧皮瓣。结果本组患者术后切口均工期愈合，无皮下血肿、皮缘坏死、切口感染等术后早期并发症发生。随访1—6个月，平均3．3个月，无一例复发。按中华医学会手外科学会上肢部分功能评定试用标准评定：患手运动功能优9例，良2例；优良率为100％。结论在掌腱膜部分切除术中以游离植皮的理念处理掌侧皮肤可明显降低术后早期并发症。

Objective To investigate a modified technique in the surgical treatment of Dupuytren＇ s contracture and its clinical outcomes. Methods Eleven cases in 9 patients of Dupuytren＇ s contracture were treated by partial resection of the palmar aponeurosis from September 2008 to August 2009. The conventional method was modified by treating the skin flap as a skin graft. Results Primary wound healing was achieved in all cases. There was no infection, hematoma or skin necrosis. The follow-up period ranged from 1 to 6 months, with an average ~ 3.3 months. There was no recurrence. The results were graded as good in 9 cases and fair in 2 cases according to the upper limb functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association. The overall satisfactory rate was 100%. Conclusion Early postoperative complication rate can be greatly reduced by treating palmar skin flap as free skin graft after partial resection of the palmar aponeurosis.