Dupuytren Kontraktürü: Parsiyel Fasiektomi Uygulanan 32 Hastanın Retrospektif Analizi

Yıl 2019, Cilt: 45 Sayı: 2, 119 - 123, 01.08.2019

Sercan Çapkın Tufan Kaleli

https://doi.org/10.32708/uutfd.506471

Öz

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.

Anahtar Kelimeler

Dupuytren Hastalığı, Kontraktür, Parsiyel fasiektomi

Dupuyten’ s Contracture: Retrospective Analysis of 32 Patients Operated by Partial Fasciectomy

Öz

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.

Anahtar Kelimeler

Dupuytren’ s disease, Contracture, Partial Fasciectomy

Kaynakça

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