The proximal interphalangeal joint in Dupuytren's disease

Area of Science:

• Orthopedics and Hand Surgery

Background:

• Dupuytren's disease primarily affects palmar fascial structures, causing finger contractures.
• Secondary joint changes can complicate surgical correction of Dupuytren's disease.

Purpose of the Study:

• To review the surgical outcomes for Dupuytren's disease.
• To explore alternative surgical options when primary correction fails.

Main Methods:

• Analysis of 154 operations in 100 patients with Dupuytren's disease.
• Review of joint anatomy and mechanisms of contracture.

Main Results:

• Average pre-operative proximal interphalangeal joint contracture was 42 degrees.
• Average improvement in joint extension was 41%.
• 14 amputations (9.1%) were performed.

Conclusions:

• Surgical intervention for Dupuytren's disease yields moderate improvements in joint extension.
• Amputation is a consideration when conservative surgical approaches are insufficient.
• Arthrodesis, osteotomy, and joint replacement are viable alternatives to amputation.