Dupuytren Disease Surgical Treatment: A Randomized Clinical Trial Comparing Partial Fasciectomy by Bruner Approach Versus Zetaplasty.

IF 1.8 Q2 ORTHOPEDICS HAND Pub Date : 2024-11-01 Epub Date: 2023-07-23 DOI:10.1177/15589447231185581
Renan G Leão, Vinicius Y de Moraes, Luis R Nakachima, João C Belloti, João B G Santos
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Abstract

Background: Dupuytren is a fibroproliferative pathology leading to contracture of the palmar fascia. Several approaches have been described for the surgical treatment with partial fasciectomy with few comparisons in literature. Our purpose is to compare the functional outcomes between the partial fasciectomy performed by Bruner type incision and zetaplasty incision.

Methods: The method used was a randomized clinical trial including adult patients of both sexes with surgical indication for Dupuytren disease presented to a reference center. Patients were randomly and consecutively allocated in the groups 1:1. We recorded the Disabilities of the Arm, Shoulder, and Hand (DASH) score; range of motion for active and passive extension of the metacarpophalangeal (MP) and proximal interphalangeal (PIP) joints; visual analog scale for pain; and complications.

Results: In all, 62 patients were included, with 48 patients reaching the minimum follow-up of 6 months with 63 operated fingers. In the Bruner approach group, we obtained a correction of the active and passive extension of the MP of 28° and of the PIP of 23°. In the zetaplasty group, correction of MP was 30° for active and passive, and 18° for active extension and 16° for passive extension of the PIP. The reduction in the DASH score was 10 points in the Bruner group and 22 points in the zetaplasty group. There was no statistically significant effect of the type of treatment on preoperative and postoperative differences in any of the parameters evaluated.

Conclusions: There were no statistically significant differences between the 2 techniques for self-reported functional outcomes or objective measures of physical examination.

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杜普伊特伦病的手术治疗:比较布鲁纳法部分筋膜切除术与Zetaplasty术的随机临床试验。
背景介绍杜普伊特伦是一种导致掌筋膜挛缩的纤维增生性病变。目前已有几种筋膜部分切除术的手术治疗方法,但很少有文献对其进行比较。我们的目的是比较Bruner型切口和zetaplasty切口进行部分筋膜切除术的功能效果:方法:采用随机临床试验的方法,包括到参考中心就诊的有手术指征的杜普伊特伦病成年男女患者。患者以 1:1 的比例随机连续分配到各组。我们记录了手臂、肩部和手部残疾(DASH)评分;掌指关节(MP)和近端指间关节(PIP)主动和被动伸展的活动范围;疼痛视觉模拟量表;以及并发症:共有62名患者接受了治疗,其中48名患者的手术手指达到63个,随访时间最短为6个月。在布鲁纳方法组中,我们获得了主动和被动伸展 MP 28°和 PIP 23°的矫正效果。在Zetaplasty组中,MP的主动和被动伸展矫正为30°,PIP的主动伸展矫正为18°,被动伸展矫正为16°。Bruner组的DASH评分降低了10分,zetaplasty组降低了22分。治疗类型对术前和术后任何评估参数的差异均无统计学意义:在自我报告的功能结果或客观的体格检查指标方面,两种技术之间没有明显的统计学差异。
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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
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