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Finger contractions (Morbus Dupuytren)
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Minimal invasive treatment of Dupuytren´s contracture without
skin incisions.
Finger contractions due to fibrous formations of the palmar with fixed
flexion deformity of one ore more fingers at the metacarpophalangeal (MCP)
and proximal interphalangeal joint (PIP), (Dupuytren´s disease) can
be treated without skin incisions.
About 1.9 million people in Germany are suffering from Dupuytren´s
disease. For nine years we have been offering the technique of percutaneous
needle fasciotomie:
After local anaesthesia, a needle is moved against the fibrous band which
becomes weakened and separated from the skin. Then the fibrous band is
broken by a short and sharp extension of the finger. If nevertheless skin
splittings or lesions occur, wound healing processes quickly and uncomplicated
because skin of the palm side of the hand and fingers regenerates without
problems. No other complications have been noticed. In cases of disease
recurrence percutaneous needle fasciotomie can be repeated without traumatic
consequences for the patient.
One day after needle fasciotomie the patient can use his hand without
problems. Not even wound dressings are necessary. During two or three weeks
he should use a fixed two finger bandage but only at night.
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Percutaneous needle fasciotomie can produce lasting improvement in eight
out of ten patients suffering from Dupuytren´s contracture. The
ordinary open operative method of treatment is done by zig zag cutaneous
incisions of the palmar and palmar finger skin: The fibrous material is
removed. The procedure is made under loco-regional anaesthesia or general
anaesthesia. In many cases the procedure is done in hospitals as a one
or more day treatment.
Complications of the ordinary open operative methods are documentated:
Infections, nerve injuries, haematomata, skin circulation troubles, finger
swellings at least reflex sympathetic dystrophy of the hand. Generally, a
long time treatment after the operation is necessary, a difficult period
for the patient and the doctor.
Percutaneous needle fasciotomie for Dupuytren´s contracture is a
quasi closed method avoiding cutaneous incisions. It is a minimal invasive
treatment for the patient. The patient gets benefit within short time.
In cases of recurrence it can be repeated without major disability for
the patient. It is a real alternative to open surgery.
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