A 62-year-old man of Northern European descent presents with progressive inability to flatten his right hand. He has palpable cords in the palm extending to the ring and small fingers with 60-degree MCP joint contracture and 40-degree PIP contracture of the ring finger. He is unable to place his hand flat on a table.
What are the risk factors and describe the pathological anatomy.
When and how would you treat this patient?
Describe the surgical approach and how you protect the neurovascular bundle.
What complications can occur following fasciectomy and how do you manage them?
How do you manage recurrence after fasciectomy?
What is Dupuytren's diathesis and how does it influence management?
Opening Statement: This patient has Dupuytren's disease with ring finger MCP and PIP contractures meeting surgical criteria. I would perform limited fasciectomy with careful protection of the neurovascular bundle, which is displaced by the spiral cord.
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