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Year |
2001 |
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Question Number |
271) |
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Category |
Select |
Question
Surgical intervention is first indicated for Dupuytrens’s disease when which of the following findings is present?
1) A metacarpophalangeal joint contracture that is greater than 60 degrees and a proximal interphalangeal joint contracture of any degree
2) A metacarpophalangeal joint and a proximal interphalangeal joint contracture that are each greater than 40 degrees
3) A metacarpophalangeal joint contracture of 30 degrees and a proximal interphalangeal joint contracture of any degree
4) A metacarpophalangeal joint contracture of any degree and a proximal interphalangeal joint contracture that is greater than or equal to 30 degrees
5) Any contracture of either the metacarpophalangeal or proximal interphalangeal joints
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Answer (click for answer)
Preferred answer # 3
Surgical intervention is first indicated for Dupuytren’s disease when there is a flexion contracture of the MCP joint of greater than 30 degrees and a flexion contracture of any degree involving the PIP joint. Partial fasciectomy of the diseased tissue rather than total fasciectomy is the most widely used treatment. Unfortunately to exclude the other answers you simply have to memorize these initial criteria for surgical intervention.
Reference: McFarlane, R.M., Botz, J.S.: The results of treatment, in McFarlane R.M., McGrouther, D.A., Flint, M.A., (eds): Dupuytren’s Disease: Biology and Treatment ( The hand and upper limb series, vol 5). Edinburgh, Scotland, 1990, pp387-412