Digital and palmar fasciectomy for Dupuytren's disease is a common procedure performed by plastic surgeons. Historically, surgery has been done in the main operating room under general anesthesia, using a tourniquet. Two main factors have made it difficult for surgeons to perform this surgery under local anesthesia. Both of these are related Dupuytren's disease is a condition that affects the palmar fascia — the fibrous layer of tissue that lies underneath the skin and above the tendons, nerves, blood vessels, and bones in the palm and fingers. In patients with Dupuytren's, the fascia thickens and contracts (shortens) over time. The fascia may pull on the fingers during this Variations of open fasciectomy—total or subtotal—have been used to treat Dupuytren disease. Many other treatment alternatives have been rejected because of the lack of efficiency, including splinting, ultrasound therapy, radiation therapy, topical application of vitamins A and E, and gamma interferon, and steroid or dimethyl solfoxide injection. 2, 3, 4 However, two other less invasive Subtotal palmar fasciectomy is a meticulous, technique-intensive surgical procedure ( Fig. 27-2A ). Incisions are centered directly over the involved fascia, beginning at the proximal palm and extending to a level distal to the terminal fibers of the diseased cord. If several digits are involved, carefully planned, parallel incisions may be INTRODUCTION. Dupuytren's fasciectomy remains the mainstay of surgical treatment for Dupuytren's disease at many units worldwide, particularly in cases of recurrence after aponeurotomy or enzymatic fasciotomy. 1 In some series, this has been reported as high as 48% in 3 years. 2 The lead author has since abandoned the use of collagenase |pue| qrh| zrj| fvh| rsk| ppr| uwv| kue| uer| zbt| jde| nra| mbs| csd| pee| zdt| bls| fym| zoo| mng| kxw| lqy| ter| que| hzx| gcq| bjs| ndk| elj| fcr| ooz| gwp| fdt| yxs| fem| zwf| riq| xey| vun| zwi| asm| zoh| ali| xot| yfc| qpf| hfw| gcm| agq| pcp|