The relationship between preoperative deformity and the amount of intraoperative correction

A Recent Publication looking into the Relationship between Preoperative Deformity and the amount of Intraoperative Correction that can be achieved

Author's from Bristol set out to predict the outcome following a fasciectomy for Dupuytren's Disease, by looking at preoperative deformity and the amount of intraoperative correction achieved in Metacarpophalangeal Joints (MCPJ) and Proximal Interphalangeal Joints (PIPJ).

52 patients took part in this study, together with a mean age of 68years. Although there were only 52 participants, 72 fingers were involved, with 100 joints undergoing surgery in total. 42 MCPJ's and 58 PIPJ's were treated.

Out of the 42 MCPJ's that were treated, 41 regained full intraoperative corrections; with 37/42 maintaining correction at the six month follow-up.
Whereas 35/58 PIPJ's gained full intraoperative correction, with only 12/58 maintaining correction at the six month follow up.

This study demonstrated that on the 52 patients who took part, MCPJ intraoperative correction was more successful than PIPJ intraoperative correction. It was suggested that the extent of preoperative deformity in PIPJ's was a significant predictor of successful intraoperative correction and that larger deformities of PIPJ's were less likely to result in full correction.
However, this study also found that any intraoperative partial correction of a large deformity of the PIPJ was more likely to be sustained.

Overall the authors' proposed, the greater the preoperative deformity and intraoperative correction that patients underwent, lead to an increased chance of losing some of that correction postoperatively.

O. W. Donaldson, D. Pearson, R. Reynolds and R. K. Bhatia
From the Trauma and Orthopaedic Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, UK

The Journal of Hand Surgery (European Volume, 2010) 35E: 3: 220-223


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