Subtotal palmar fasciectomy with skin Z-plasty results in Dupuytren’s disease: Minimum one year follow-up


Uzel K., Birinci M., Cacan M., Catal B., Uzun A., Kara A.

Hand and Microsurgery, vol.13, no.1, pp.21-27, 2024 (Peer-Reviewed Journal)

  • Publication Type: Article / Article
  • Volume: 13 Issue: 1
  • Publication Date: 2024
  • Doi Number: 10.5455/handmicrosurg.168109
  • Journal Name: Hand and Microsurgery
  • Journal Indexes: TR DİZİN (ULAKBİM)
  • Page Numbers: pp.21-27
  • Istanbul Medipol University Affiliated: Yes

Abstract

Backround Dupuytren's disease is a condition that leads to progressive contractures in the hand, significantly impacting the quality of life. These rigid deformities impair hand functions and have adverse effects on daily life. Various surgical treatment options are available. In this study, our goal is to report the results of patients for whom we performed subtotal palmar fasciectomy and skin Z-plasty. Method A retrospective analysis was conducted on 16 patients who underwent subtotal palmar fasciotomy. The range of motion before and after the operation, along with patient-reported outcome scores using the Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (QDASH), were compared. Additionally, the time return to work time and any complications were documented. Results The mean preoperative MCP joint flexion contracture degree was 42.8 (range: 30-70 degrees), while the postoperative mean was 2 (range: 0-30 degrees). Similarly, the mean preoperative PIP joint flexion contracture degree was 41 (range: 20-90 degrees), and the postoperative mean was 8 (range: 0-30 degrees). The mean preoperative QDASH score decreased from 44 (range: 32.5-50) to 9.6 postoperatively (range: 7.5-12.5). The average return-to-work time was 42 days. Conclusion Subtotal palmar fasciotomy stands as a surgical alternative with high patient satisfaction in treating Dupuytren's disease. The application of Z-plasty during closure helps to reduce postoperative wound problems by alleviating tension.