{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T22:43:07Z","timestamp":1749249787691},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die Konzepte zur Behandlung der Dupuytrenschen Kontraktur differieren erheblich. Nichtsdestotrotz bleibt die partielle Aponeurektomie die operative Methode der Wahl bei fortgeschrittener Erkrankung. Ein wesentlicher Aspekt dieser Operation ist ein korrekter Zugangsweg. Unter Einbeziehung der Literatur erfolgt die Darstellung grundlegender Prinzipien, sowie des konkreten eigenen Vorgehens bei unterschiedlichen Ausgangsbefunden.<\/jats:p><jats:p>Voraussetzung f\u00fcr eine korrekte Operationsplanung und damit einer ad\u00e4quaten Schnittf\u00fchrung ist neben sorgf\u00e4ltiger Anamnese eine subtile Erfassung des individuellen Befundes. Relevante Parameter sind Befundausdehnung und Hautqualit\u00e4t. Anerkannte Basisinzisionen sind an den Fingern L\u00e4ngsinzisionen mit Aufl\u00f6sung durch Z-Plastiken und Zick-Zack-Inzisionen mit vielen Variationen. Bei ausgepr\u00e4gterem Hautdefizit kommen Lappenplastiken zum Einsatz. In der Hohlhand bevorzugen wir einen ulnarseitig gestielten Lappen, alternativ eine Hohlhand-Z-Plastik. Befundabh\u00e4ngig sind Kombinationen notwendig. Entscheidend ist die Beachtung handchirurgischer Prinzipien, suffiziente Exposition des Situs, Ausnutzung verschieblicher Hautareale und die Beachtung der Vaskularisation resultierender Hautlappen.<\/jats:p><jats:p>Bei komplexem Ausgangsbefund ist eine individualisierte Schnittf\u00fchrung unter Beachtung der handchirurgischen Grundprinzipien mit Ausgleich des antizipierten Hautdefizits ein wesentliches Element f\u00fcr den Erfolg des Eingriffes, wobei die konkrete Umsetzung bei erfahrenen Handchirurgen stark variieren kann.<\/jats:p>","DOI":"10.1055\/a-1808-6902","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T23:35:18Z","timestamp":1654904118000},"page":"223-235","source":"Crossref","is-referenced-by-count":1,"title":["Zug\u00e4nge bei Operationen einer Dupuytren\u2019schen Kontraktur"],"prefix":"10.1055","volume":"54","author":[{"given":"Karlheinz","family":"Kalb","sequence":"additional","affiliation":[{"name":"Rh\u00f6n-Klinikum AG Klinik f\u00fcr Handchirurgie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob Richard","family":"Schnegg","sequence":"additional","affiliation":[{"name":"Rh\u00f6n-Klinikum AG Klinik f\u00fcr Handchirurgie"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Polina","family":"Dimitrova","sequence":"additional","affiliation":[{"name":"Rh\u00f6n-Klinikum AG Klinik f\u00fcr Handchirurgie"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,6,10]]},"reference":[{"key":"ref1","first-page":"295","volume-title":"An overview of operative treatment","author":"D A McGrouther","year":"1990"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.2106\/00004623-195436060-00012","article-title":"Arterial vascularization of the soft tissues of the hand","volume":"36","author":"H Conway","year":"1954","journal-title":"J Bone Joint Surg Am"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S0007-1226(51)80006-7","article-title":"Incisions for plastic and reconstructive (non-septic) surgery of the hand","volume":"4","author":"J M Bruner","year":"1951","journal-title":"Br J Plast Surg"},{"key":"ref4","first-page":"441","volume-title":"Die Eingriffe bei der Dupuytrenschen Kontraktur","author":"J Geldmacher","year":"1972"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1177\/1753193408095353","article-title":"Anatomical study of the palmar intermetacarpal perforator flap","volume":"34","author":"P Pelissier","year":"2009","journal-title":"J Hand Surg Eur Vol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/S0007-1226(64)80043-6","article-title":"The open palm technique in Dupuytren\u02bcs contracture","volume":"17","author":"C R McCash","year":"1964","journal-title":"Br J Plast Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1097\/00006534-196205000-00006","article-title":"Y-V advancement pedicles in surgery for Dupuytren\u02bcs contracture","volume":"29","author":"E G Deming","year":"1962","journal-title":"Plast Reconstr Surg Transplant Bull"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/S0363-5023(79)80158-6","article-title":"Treatment of Dupuytren\u2018s contracture by extensive fasciectomy through multiple Y-V-plasty incisions: Short-term evaluation of 170 consecutive operations","volume":"4","author":"E W King","year":"1979","journal-title":"J Hand Surg Am"},{"key":"ref9","first-page":"362","article-title":"Open palm technique for Dupuytren\u02bcs disease. A five-year follow-up","volume":"11","author":"G Foucher","year":"1992","journal-title":"Ann Chir Main Memb Super"},{"key":"ref10","first-page":"89","volume-title":"Dupuytren\u02bcs Contracture","author":"F Schernberg","year":"1994"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1177\/1753193411404338","article-title":"A new surgical approach to Dupuytren\u02bcs disease","volume":"36","author":"I Edmunds","year":"2011","journal-title":"J Hand Surg Eur Vol"},{"key":"ref12","first-page":"231","article-title":"A modified McCash operation for Dupuytren\u02bcs contracture","volume":"11","author":"K Jacobsen","year":"1977","journal-title":"Scand J Plast Reconstr Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/S0266-7681(98)80025-9","article-title":"The V-Y Palmar flap","volume":"23","author":"M A Rider","year":"1998","journal-title":"J Hand Surg Br"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s00064-015-0435-3","article-title":"Lappenplastiken bei fortgeschrittenem Morbus Dupuytren","volume":"28","author":"B Lukas","year":"2016","journal-title":"Oper Orthop Traumatol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s00064-012-0211-6","article-title":"Laterodorsaler Transpositionslappen zum Verschluss eines Weichteildefekts am palmaren Kleinfingergrundglied nach Aufl\u00f6sung einer Dupuytren-Rezidivbeugekontraktur","volume":"28","author":"L Walle","year":"2016","journal-title":"Oper Orthop Traumatol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1055\/s-2002-32304","article-title":"Die fortgeschrittene Dupuytrensche Kontraktur des Mittelgelenkes: Ist die Arthrolyse bei fortbestehender Fehlstellung nach Resektion des Kontrakturgewebes sinnvoll?","volume":"34","author":"K Beyermann","year":"2002","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/s00064-015-0427-3","article-title":"Die erg\u00e4nzende Mittelgelenkarthrolyse bei der operativen Behandlung einer Dupuytren\u2019schen Beugekontraktur am Finger","volume":"28","author":"B Hohendorff","year":"2016","journal-title":"Oper Orthop Traumatol"},{"key":"ref18","first-page":"607","volume-title":"Dupuytrensche Kontraktur \u2013 Rezidiveingriffe","author":"U Lanz","year":"2000"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/J.JHSB.2004.02.002","article-title":"Severe contracture of the proximal interphalangeal joint in Dupuytren\u02bcs disease: does capsuloligamentous release improve outcome?","volume":"29","author":"K Beyermann","year":"2004","journal-title":"J Hand Surg Br"},{"key":"ref20","first-page":"1219","article-title":"Capsulectomy of the interphalangeal joints of the fingers","volume":"36-a","author":"R M Curtis","journal-title":"J Bone Joint Surg Am 1954"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1097\/00006534-199603000-00011","article-title":"Severe contractures of the proximal interphalangeal joint in Dupuytren\u02bcs disease: combined fasciectomy with capsuloligamentous release versus fasciectomy alone","volume":"97","author":"N Weinzweig","journal-title":"Plast Reconstr Surg 1996"},{"key":"ref22","first-page":"345","article-title":"Total anterior teno-arthrolysis. 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