Book contents
- Frontmatter
- Contents
- Preface
- 1 The elective repair of an abdominal aortic aneurysm
- 2 Adrenalectomy
- 3 Amputation (below knee)
- 4 Anorectal abscesses, fistulae and pilonidal sinus
- 5 Appendicectomy
- 6 Principles of bowel anastomosis
- 7 Breast surgery
- 8 Carotid endarterectomy
- 9 Carpal tunnel decompression
- 10 Central venous cannulation
- 11 Cholecystectomy (laparoscopic)
- 12 Circumcision
- 13 Colles' fracture (closed reduction of)
- 14 Compound fractures
- 15 Dupuytren's contracture release
- 16 Dynamic hip screw
- 17 Fasciotomy for compartment syndrome
- 18 Femoral embolectomy
- 19 Femoral hernia repair
- 20 Haemorrhoidectomy
- 21 Hip surgery
- 22 Hydrocele repair
- 23 The open repair of an inguinal hernia
- 24 Laparotomy and abdominal incisions
- 25 Oesophago-gastroduodenoscopy
- 26 Orchidectomy
- 27 Parotidectomy
- 28 Perforated peptic ulcer
- 29 Pyloric stenosis and Ramstedt's pyloromyotomy
- 30 Right hemicolectomy
- 31 Skin cover (the reconstructive ladder)
- 32 Spinal procedures
- 33 Splenectomy
- 34 Stomas
- 35 Submandibular gland excision
- 36 Tendon repairs
- 37 Thoracostomy (insertion of a chest drain)
- 38 Thoracotomy
- 39 Thyroidectomy
- 40 Tracheostomy
- 41 Urinary retention and related surgical procedures
- 42 Varicose vein surgery
- 43 Vasectomy
- 44 Zadik's procedure
15 - Dupuytren's contracture release
Published online by Cambridge University Press: 16 October 2009
- Frontmatter
- Contents
- Preface
- 1 The elective repair of an abdominal aortic aneurysm
- 2 Adrenalectomy
- 3 Amputation (below knee)
- 4 Anorectal abscesses, fistulae and pilonidal sinus
- 5 Appendicectomy
- 6 Principles of bowel anastomosis
- 7 Breast surgery
- 8 Carotid endarterectomy
- 9 Carpal tunnel decompression
- 10 Central venous cannulation
- 11 Cholecystectomy (laparoscopic)
- 12 Circumcision
- 13 Colles' fracture (closed reduction of)
- 14 Compound fractures
- 15 Dupuytren's contracture release
- 16 Dynamic hip screw
- 17 Fasciotomy for compartment syndrome
- 18 Femoral embolectomy
- 19 Femoral hernia repair
- 20 Haemorrhoidectomy
- 21 Hip surgery
- 22 Hydrocele repair
- 23 The open repair of an inguinal hernia
- 24 Laparotomy and abdominal incisions
- 25 Oesophago-gastroduodenoscopy
- 26 Orchidectomy
- 27 Parotidectomy
- 28 Perforated peptic ulcer
- 29 Pyloric stenosis and Ramstedt's pyloromyotomy
- 30 Right hemicolectomy
- 31 Skin cover (the reconstructive ladder)
- 32 Spinal procedures
- 33 Splenectomy
- 34 Stomas
- 35 Submandibular gland excision
- 36 Tendon repairs
- 37 Thoracostomy (insertion of a chest drain)
- 38 Thoracotomy
- 39 Thyroidectomy
- 40 Tracheostomy
- 41 Urinary retention and related surgical procedures
- 42 Varicose vein surgery
- 43 Vasectomy
- 44 Zadik's procedure
Summary
What is Dupuytren's disease?
This is a nodular thickening of the palmar aponeurosis leading to flexion contractures of the fingers at the metacarpophalangeal joint (MCPJ) and/or proximal interphalangeal joint (PIPJ) of the fingers. The ring and little fingers are most commonly affected. The condition has a higher prevalence in people from northern European descent.
What conditions are associated with Dupuytren's disease?
This condition is mainly idiopathic and familial (autosomal dominant), however there is a high incidence in epileptics on phenytoin and is also known to be associated with diabetes, alcoholic cirrhosis, AIDS and pulmonary tuberculosis.
What other associated clinical manifestations of Dupuytren's disease do you know?
Thickenings on the dorsum of the fingers (Garrod's pads)
Thickening of the plantar fascia of the feet
Thickening and fibrosis of the corpous cavernosum of the penis (Peyronie's disease)
What are the surgical options in treating the condition?
Fasciotomy: Release of the contracture without excising the thickened bands.
Fasciectomy: Excision of all diseased bands contributing to the deformity.
Dermatofasciectomy: As above with the addition of a full-thickness skin graft to an excised skin defect.
Amputation: May be necessary in severe recurrent disease.
Briefly discuss how you would perform a Dupuytren's excision
Position This is supine with the affected arm on a supporting table. The hand and forearm are then prepared and draped. The arm is exsanguinated and a tourniquet is applied.
Incision: A zigzag or Brunner incision is made from midpalm proximal to the contracture and into the finger. Skin flaps are then carefully raised.
- Type
- Chapter
- Information
- Operative Surgery Vivas for the MRCS , pp. 53 - 56Publisher: Cambridge University PressPrint publication year: 2006