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[Preoperative intermittent pneumatic extension treatment stage III and IV Dupuytren contracture]
H Piza-Katzer1, E Herczeg, R Aspek
1Abteilung für Plastische und Wiederherstellungschirurgie des Krankenhauses Lainz, Wien.
Background:
The purpose of this study was the development of a non-invasive preoperative soft-tissue extension device for the treatment of patients with Dupuytren's contracture grade III and IV according to the classification of Tubiana, based on the experience of continuous extension treatment using the external fixator of Messina.
Methods:
Intermittent pneumatic distraction (IPD) of soft tissue using a pneumatic extension device was employed for three weeks preoperatively on ten patients.
Results:
After three weeks the active and passive extension deficit was reduced by 30.02% and 44.64% respectively. Eight months postoperatively an increase of extension on average of 110 degrees was attained. In contrast, a second group of ten patients with Dupuytren's contracture grade III and IV (Tubiana) without preliminary treatment was listed. In these patients, three times a skin graft was needed; in addition, the stay in hospital and time of rehabilitation was longer.
Conclusions:
The preoperative reduction of contracture simplifies the surgical treatment and reduces the complication rate. We present a new non-invasive technique for preoperative continuous extension of Dupuytren's contracture yielding at least equal results to the method introduced by Messina. Comparing the two groups of patients, the patients with preliminary treatment had a shorter stay in the hospital and a shorter time of rehabilitation.