Abstract
Introduction and Aims: Severe Dupuytren’s contracture of the proximal interphalangeal (PIP) joint is a difficult condition to treat; a two-stage technique has been advocated by some surgeons for such cases. The present study set out to determine the early results of this technique.
Method: Thirteen patients (11 with primary and two with recurrent disease) with a severe Dupuytren’s contracture of the proximal interphalangeal (PIP) joint were treated by geometric correction (in line distraction followed by angular correction) using the OrthofixTM mini external fixator followed by its removal and partial fasciectomy (without collateral ligament or volar plate release). The mean duration of distraction was 14 days.
Results: In the PIP joint the mean true fixed flexion deformity pre-operatively was 75 degrees (range 45–90). At a mean follow-up of 21 months, the mean residual flexion deformity was 35 degrees (range 10–90). The mean arc of motion increased from 26 (range 10–55) to 51 degrees (range 0–90). At follow-up, the mean arc of motion was 33 degrees (range 0–70) and 73 degrees (range 45–110) at the distal interphalangeal and meta-carpophalangeal joints respectively. There were no cases of reflex sympathetic dystrophy or neurovascular damage. One patient had a fracture of the proximal phalanx and a second patient had an early recurrence, which led to a poor clinical outcome. The rest had an excellent clinical outcome according to the Michigan Hand Questionnaire.
Conclusion: Although the technique is challenging, the early results are promising and we recommend it for the management of this difficult problem.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
None of the authors is receiving any financial benefit or support from any source.
