The Incidence of Postoperative Flare Reaction and Tissue Complications in Dupuytren's Disease Using Tension-Free Immobilization

Author:

Rivlin Michael,Osterman Meredith1,Jacoby Sidney M.1,Skirven Terri1,Ukomadu Uzoma2,Osterman A. Lee1

Affiliation:

1. The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, PA, USA

2. Thomas Jefferson University, Philadelphia, PA, USA

Abstract

Purpose Open fasciectomy represents a standard treatment of Dupuytren's disease. Although patients are commonly immobilized in extension to prevent postoperative contracture formation, immobilizing the extremity under tension may precipitate a flare reaction and scar-related complications. This study explores the incidence of flare reaction and other complications with postoperative tension-free splinting after fasciectomy for Dupuytren's contracture. Methods We retrospectively reviewed patients' charts that consisted of 228 procedures in 191 patients who underwent surgery by the senior author between 2000 and 2010. Postoperative notes were reviewed for wound healing problems, scar appearance, flare reaction, and complications. The grading system defined by Evans et al. was used to standardize flare reaction and scar complications. Results Using tension-free splinting, the incidence of flare reaction was 3.5 % (8/228). The eight patients that had flare reactions had mild involvement, and no severe reaction was observed. Fifteen patients had hypertrophic scars, eight had hypersensitive scars, and six had recurrent contractures. Conclusions The incidence of flare reaction using tension-free immobilization postoperatively was low in our study. According to our findings, wound healing problems are rare when tensionless splinting is utilized. Type of study/level of evidence Case series, Level IV, Therapeutic study

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine,Surgery

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