Dupuytren kontraktürü: parsiyel fasiektomi uygulanan 32 hastanın retrospektif analizi
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Date
2019-04-08
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Bursa Uludağ Üniversitesi
Abstract
Dupuytren kontraktürü nedeniyle parsiyel fasiektomi uyguladığımız 32 hastanın demografik ve klinik özellikleri, fonksiyonel sonuçları, komplikasyon ve nüks oranları güncel literatür eşliğinde tartışıldı. Çalışmamızda; erkek/kadın oranı: 7/1, hastalığın başlangıcındaki ortalama yaş 55.4±7.1, cerrahi esnasındaki ortalama yaş 60.4±8.1 olarak tespit edildi. 7 hastada (%21.875) aile öyküsü, 22 hastada (%68.75) sigara kullanımı, 6 hastada (%18,75) düzenli alkol kullanımı, 10 hastada (%31,25) tip 2 diyabet, 2 hastada (%6.25) karaciğer hastalığı, 1 hastada (%3.125) epilepsiye bağlı uzun süre barbitürat kullanımı gibi etiyolojik faktörler mevcuttu. En sık etkilenen parmak 26 hasta (%81.25) ile yüzük parmağı olup, 18 hastada (%56.25) küçük parmak, 8 hastada (%25) orta parmak, 1 hastada (%3.125) işaret parmağı tutulumu vardı. Ameliyat öncesi, ortalama total pasif ekstansiyon kaybı (TPEK) 89.68º±30.29, ameliyat sonrası ortalama TPEK 6.09º±6.44 olarak bulundu. Ameliyat sonrası ortalama total ekstansiyon kazancı %93.2 olarak bulundu. Ortalama takip süresi 70±44 ay olup, bu süre içerisinde 1 hastada (%3.125) nüks görüldü. 2 hastada pansumanlara sekonder iyileşen cilt nekrozu, 1 hastada geçici hipoestezi olmak üzere toplam 3 hastada (%9.375) komplikasyon meydana geldi. MKF ve PİP eklem kontraktüründe yeterli düzelme sağlaması, komplikasyon ve nüks oranlarının düşük olması nedeniyle parsiyel fasiektomi dupuytren kontraktürünün cerrahi tedavisinde etkili ve güvenilir bir yöntemdir.
Demographic and clinical features of 32 patients diagnosed with dupuytren contracture and operated by partial fasciectomy were included in this study. Functional results, complications and recurrence rates were discussed with current literature. In our study male/female ratio was 7/1, mean age at onset of disease was 55.4±7.1, mean age at surgery was 60.4±8.1. There were etiological factors such as a family history in 7 patients (21.875%), smoking in 22 patients (68.75%), regular alcohol use in 6 patients (%18,75), type 2 diabetes in 10 patients (31.25%), hepatic disease in 2 patients (6.25%), long term barbiturate use for epilepsy in 1 patients (3.125%). The most often involved finger was the ring finger in 26 patients (81.25%), the small finger in 18 patients (56.25%), middle finger in 8 patients (25%) and index finger in 1 patient (3.125%). The pre-operative mean total passive extension deficit (TPEK) was 89.68º±30.29, the post-operative mean TPED was 6.09º±6.44. The post-operative mean total extension gain was 93.2%. The mean follow-up was 70±44 months, 1 patient (3.125%) had a recurrence in this period. The overall complications occured in 3 patients (9.375%), including skin necrosis in 2 patients (treated with dressings) and temporary hypoesthesia in 1 patient. The partial faciectomy is an effective and reliable method for the surgical treatment of dupuyren contracture because of improvement enough correction in the MCF and PIP joint contracture, the low rate of complication and recurrence rates.
Demographic and clinical features of 32 patients diagnosed with dupuytren contracture and operated by partial fasciectomy were included in this study. Functional results, complications and recurrence rates were discussed with current literature. In our study male/female ratio was 7/1, mean age at onset of disease was 55.4±7.1, mean age at surgery was 60.4±8.1. There were etiological factors such as a family history in 7 patients (21.875%), smoking in 22 patients (68.75%), regular alcohol use in 6 patients (%18,75), type 2 diabetes in 10 patients (31.25%), hepatic disease in 2 patients (6.25%), long term barbiturate use for epilepsy in 1 patients (3.125%). The most often involved finger was the ring finger in 26 patients (81.25%), the small finger in 18 patients (56.25%), middle finger in 8 patients (25%) and index finger in 1 patient (3.125%). The pre-operative mean total passive extension deficit (TPEK) was 89.68º±30.29, the post-operative mean TPED was 6.09º±6.44. The post-operative mean total extension gain was 93.2%. The mean follow-up was 70±44 months, 1 patient (3.125%) had a recurrence in this period. The overall complications occured in 3 patients (9.375%), including skin necrosis in 2 patients (treated with dressings) and temporary hypoesthesia in 1 patient. The partial faciectomy is an effective and reliable method for the surgical treatment of dupuyren contracture because of improvement enough correction in the MCF and PIP joint contracture, the low rate of complication and recurrence rates.
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Keywords
Dupuytren hastalığı, Kontraktür, Parsiyel fasiektomi, Dupuytren’s disease, Contracture, Partial fasciectomy
Citation
Çapkın, S. ve Kaleli, T. (2019). "Dupuytren kontraktürü: parsiyel fasiektomi uygulanan 32 hastanın retrospektif analizi". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 45(2), 119-123.