Dupuytren’s Contracture

Preliminary Soft-Tissue Distraction versus Checkrein Ligament Release after Fasciectomy in the Treatment of Dupuytren Proximal Interphalangeal Joint Contractures

Craft RO, Smith AA, Coakley B, et al (Mayo Clinic, Scottsdale, AZ) Plast Reconstr Surg 128:1107-1113, 2011^§

Abstract

Background

Checkrein ligament release for treatment of proximal interphalangeal joint Dupuytren contractures does not address the shortened arteries or deficient skin. The Digit Widget uses soft-tissue distraction to overcome these issues. This study compares checkrein ligament release after fasciectomy versus preliminary soft-tissue distraction, followed by operative release, for treatment of proximal interphalangeal joint Dupuytren contractures.

Methods

The authors compared operative and postoperative characteristics of patients treated with either fasciectomy plus checkrein ligament release or Digit Widget distraction between 2001 and 2008. Seventeen patients (20 digits) underwent ligament release (mean contracture, 55.9 degrees); six of these 20 were reoperations. Thirteen patients (17 digits) underwent distraction (mean contracture, 67.6 degrees); 10 of 17 were reoperations.

Results

The 20 digits treated with fasciectomy plus ligament release had an average extension improvement of 31.4 degrees (range, −4 to 70 degrees). Digits treated with distraction had an average extension improvement of 53.4 degrees (range, 30 to 75 degrees) (p

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