Article
Severe Dupuytrens Contracture treated by the McCash Technique (open palm) and Full Thickness Skin Grafts to the Involved Fingers: Results and Complications
Search Medline for
Authors
Published: | February 6, 2020 |
---|
Outline
Text
Objective: We hypothesized that using an open palm technique and full thickness skin grafts would result in satisfactory correction of the flexion contractures with minimal complications.
Methods: 95 patients with severe Dupuytrens contracture were operated on between 2010 and 2017 by the senior authors. The patients were evaluated pre and post op by the surgeons. The average follow up was 18 months.
We evaluated:
- 1.
- ROM of MCPs + PIPs pre and post op
- 2.
- Post- operative pain
- 3.
- Time for healing of the open wound
- 4.
- Complications:
- flare reaction (RSD)
- loss of FTSG
- nerve injury
Results: Patients were all seen initially at 3-5 days post op. They were then followed 2 weeks post-op. The average VAS pain score was 3.4 at 3-5 days post op and all patients were off any strong medication by 1 week.
ROM pre-op post-op
MCP5 degrees 55 degrees
PIP25 degrees 75 degrees
Time for healing of open of open wound was 18 days.
Complications:
- flare reaction (RSD symptoms)- 3
- loss of FTSG- 2
- nerve injury/ neuropraxia- 2
Conclusion: Severe Dupuytrens contracture can safely be treated by using an open palm technique and small transverse finger incisions. Defects in the fingers are treated by full thickness skin grafts. The use of the open technique and small incisions results in very few severe complications.