Monday, November 16, 2009

The Open Palm Technique for Dupuytren's

The Open Palm Technique for Dupuytren's contracture has advantages - lack of hematoma, lower incidence of sympathetic dystrophy. The classic McCash version of this procedure combines closure of zigzag finger incisions, leaving transverse palm wounds open. The Burkhalter version, developed by Dr. Mann, employs only transverse incisions in the palm and fingers, all of which are left open. Proponents of the Burkhalter technique believe that it leads to fewer recurrences, but there are no studies yet to back this up. Available evidence suggests that individual patient biology is the main influence on recurrence and that the incidence of some complications varies with procedure. This study of the McCash open palm technique confirms that the rates of complications (21%) and recurrence (33% at 2 1/2 years) remain issues even the hands of experienced surgeons: http://www.dupuytrenfoundation.org/DupPDFs/1994_Cools.pdf

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