6533b82dfe1ef96bd1291bf9

RESEARCH PRODUCT

The “Jacobsen Flap” for the Treatment of Stage III–IV Dupuytren’s Disease at Little Finger: Our Review of 123 Cases

subject

description

For selective fasciectomy in patients with Dupuytren’s disease at Tubiana Stage I–II, midline longitudinal incisions with serial Z-plasties, Bruner zigzag incisions, and V-Y plasties over the palm and most severely affected fingers are accepted methods. Advantages of these approaches are good intraoperative visualization of the fibrous tissue, rapid dissection, minor tissue trauma, and usually the possibility of a tension-free wound closure (Brenner and Rayan 2003). In cases of Dupuytren’s disease at Stage III and IV, with severe digital flexion, inelastic overlying skin, and expected skin shortage after contracture release, these incisions may sometimes be useful, but in our experience, quite often are insufficient, since they may increase the risk of edema, skin necrosis, and wound breakdown. In these cases, dermofasciectomy with full-thickness skin grafting and the McCash technique (McCash 1964) are more often performed (Brenner and Rayan 2003), with different rates of complications and recurrence (Lubahn 1996, 1999).