Dupuytren contracture: comparative study between partial fasciectomy and percutaneous fasciectomy / Contratura de Dupuytren: estudo comparativo entre fasciectomia parcial e fasciotomia percutânea

Objectives: To compare the clinical results obtained by using the techniques of open limited fasciectomy (FP) and percutaneous needle fasciectomy (FPC) in patients with Dupuytren's contracture after one year follow up. Methods: Thirty-three patients and a total of 50 fingers with Dupuytren's contracture were divided non-randomly and evaluated after undergoing procedures with FP or FPC. The results were evaluated based on the Tubiana classification, DASH score (Disabilities of the Arm, Shoulder, and Hand), time until return to professional activities, total passive extension deficit (DTEP), the relationship between the extension deficit and DASH, recurrence and complications. Results: Twenty-six fingers were treated with FPC technique and 24 fingers with FP. The DTEP was significantly lower in FP group (10.23º ) when compared to FPC group (23.46º) at 12 months postoperatively (p = 0.038). The remaining items assessed did not show any statistically significant differences. Conclusion: Total passive extension deficit at 12 months is lower in the group of open limited fasciectomy. There are no significant differences between groups FP and FPC over the classification of Tubiana, the DASH score, time until return to professional activities and the incidence of recurrence. .

Objetivos: Comparar os resultados clínicos das técnicas de fasciectomia parcial (FP) e fasciotomia percutânea (FPC) em pacientes acometidos pela contratura de Dupuytren com seguimento de um ano. Métodos: Trinta e três pacientes e 50 dedos com a contratura de Dupuytren foram divididos de forma não randomizada e avaliados após serem submetidos à FP ou à FPC. As avaliações incluíram a classificação de Tubiana, o escore funcional DASH (Disabilities of the Arm, Shoulder, and Hand), o tempo de retorno às atividades profissionais, o déficit total de extensão passiva (DTEP), a relação entre o DTEP e o escore DASH, a recidiva e as complicações. Resultados: No total, 26 dedos foram tratados pela técnica de FPC e 24 pela de FP. O DTEP apresentou-se significativamente menor no grupo da FP (10,23º) em relação ao grupo da FPC (23,46º), aos 12 meses (p =0,038). Os demais itens avaliados não apresentaram diferenças estatisticamente significativas. Conclusão: O déficit total de extensão passiva, aos 12 meses, é menor no grupo da FP. Não existemdiferenças significativas entre os grupos FPe FPCquanto à classificaçãode Tubiana, ao escore DASH, ao tempo de retorno às atividades profissionais e à incidência de recidiva. .

Dupuytren contracture: comparative study between partial fasciectomy and percutaneous fasciectomy.

OBJECTIVES: To compare the clinical results obtained by using the techniques of open limited fasciectomy (FP) and percutaneous needle fasciectomy (FPC) in patients with Dupuytren's contracture after one year follow up. METHODS: Thirty-three patients and a total of 50 fingers with Dupuytren's contracture were divided non-randomly and evaluated after undergoing procedures with FP or FPC. The results were evaluated based on the Tubiana classification, DASH score (Disabilities of the Arm, Shoulder, and Hand), time until return to professional activities, total passive extension deficit (DTEP), the relationship between the extension deficit and DASH, recurrence and complications. RESULTS: Twenty-six fingers were treated with FPC technique and 24 fingers with FP. The DTEP was significantly lower in FP group (10.23°) when compared to FPC group (23.46°) at 12 months postoperatively (p = 0.038). The remaining items assessed did not show any statistically significant differences. CONCLUSION: Total passive extension deficit at 12 months is lower in the group of open limited fasciectomy. There are no significant differences between groups FP and FPC over the classification of Tubiana, the DASH score, time until return to professional activities and the incidence of recurrence.

OBJETIVOS: Comparar os resultados clínicos das técnicas de fasciectomia parcial (FP) e fasciotomia percutânea (FPC) em pacientes acometidos pela contratura de Dupuytren com seguimento de um ano. MÉTODOS: Trinta e três pacientes e 50 dedos com a contratura de Dupuytren foram divididos de forma não randomizada e avaliados após serem submetidos à FP ou à FPC. As avaliações incluíram a classificação de Tubiana, o escore funcional DASH (Disabilities of the Arm, Shoulder, and Hand), o tempo de retorno às atividades profissionais, o déficit total de extensão passiva (DTEP), a relação entre o DTEP e o escore DASH, a recidiva e as complicações. RESULTADOS: No total, 26 dedos foram tratados pela técnica de FPC e 24 pela de FP. O DTEP apresentou-se significativamente menor no grupo da FP (10,23°) em relação ao grupo da FPC (23,46°), aos 12 meses (p = 0,038). Os demais itens avaliados não apresentaram diferenças estatisticamente significativas. CONCLUSÃO: O déficit total de extensão passiva, aos 12 meses, é menor no grupo da FP. Não existem diferenças significativas entre os grupos FP e FPC quanto à classificação de Tubiana, ao escore DASH, ao tempo de retorno às atividades profissionais e à incidência de recidiva.

Comparison of acupuncture to injection for myofascial trigger point pain.

OBJECTIVES: Many treatments have been proposed for myofascial pain syndrome. The objective of this study was to compare the analgesic effect of acupuncture to trigger point injection combined with cyclobenzaprine chlorhydrate and sodium dipyrone. METHODS: A randomized study was performed in 30 patients divided into 2 groups: G1 received trigger point injection with 0.25% bupivacaine twice weekly, and both cyclobenzaprine chlorhydrate 10 mg/day and sodium dipyrone 500 mg every 8 hours; G2 received classical and trigger point acupuncture twice weekly. All patients were instructed in physical exercise. The following parameters were evaluated: pain intensity rated on a numerical scale, number of trigger points, and quality of life before and 4 weeks after treatment. RESULTS: The pain scores and the number of trigger points reduced significantly in both groups, with no significant difference between groups. Significant improvement in the quality of life scores was observed for some of the functional domains in the 2 groups, whereas there was no improvement of the general health status domain in either group or of the emotional domain in G1. CONCLUSION: Acupuncture, when compared with trigger point injection, combined with cyclobenzaprine chlorhydrate and sodium dipyrone provided similar pain relief and improvement in quality of life measures at 4 weeks.