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DOI: 10.1055/s-0042-1758547
Arthrodesis of the Proximal Interphalangeal Joint in Dupuytren Contracture: A Qualitative Systematic Review
Article in several languages: español | EnglishAbstract
Introduction One of the typical features of Dupuytren contracture is its tendency for recurrence. Reintervention surgery has a high rate of complications, which increases with successive surgeries. Repeated fasciectomies can be contraindicated in severe, recurrent contractures, with arterial insufficiency or poor-quality soft tissue, due to a risk of severely compromising the viability of the skin. In these cases, finger amputation can be avoided by performing arthrodesis of the proximal interphalangeal (PIP) joint. Arthrodesis is also an alternative to amputation in contracted fingers affected by arthritis or arthrofibrosis of the PIP joint. Knowledge about this procedure is scarce due to its rarity. We performed a qualitative systematic review of the results and complications of arthrodesis of the PIP joint of digits 2 to 5 in adults with Dupuytren contracture.
Materials and Methods Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a search on the PubMed, Cochrane and Embase databases. The risk of bias was assessed with the modified Newcastle-Ottawa Scale. We recorded the intraoperative and postoperative variables, and those related to complications, improvement in pain and function, and the level of patient satisfaction.
Results For the systematic review, we selected 4 case series totalling 65 patients and 71 arthrodesis. Significant improvements in terms of pain and function were not observed, but, in all studies, patient satisfaction was high. The rate of complication was of 11.3%, and they included 1 case of skin necrosis, but no vascular or nervous lesions were observed.
Conclusion Despite the fact that no improvements in pain or function were reported, this procedure is associated with a high level of patient satisfaction, and an extremely low rate of skin ailments or vascular or nervous lesions. The level of evidence regarding the results and complications is low
Ethical responsibilities
The authors declare that the procedures complied with the standards of the institutional Clinical Research Ethics Committee (which approved this study) and the Declaration of Helsinki.
Data confidentiality
The authors declare that they have followed the protocols of their work center on the publication of patient data.
Publication History
Received: 09 October 2021
Accepted: 07 October 2022
Article published online:
16 December 2022
© 2022. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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