In a 50 year diabetes / alcoholic patient, presented with 15 degree flexion deformity of the little finger what is the most appropriate management.
|A||Wait and watch|
|B||Sub total fasciectomy|
Wait and watch
a. This is nodular hyper trophy and contra cture of palmar aponeurosis
b. Higher incidence in epileptics receiving phenytoin therapy, diabetics, alcoholic cirrhosisQ, AIDS, pulmonary tuberculosisQ
c. Flexion contracture most commonly occur atMP jointQ. > PIP joint > DIP joint
- Ring finger is most commonly involvedQ > little finger
Primary indication of surgery is fixed contracture of >300 at MP joint and 15 degrees at PIP joint.
a. Surgery does not cure the disease, it only partially corrects the deformity –subtotal fasciectomy is the
b. procedure of choice.
c. Fasciotomy inadequate correction.
d. Total fasciectomy higher complications-hematoma/fibrosis.