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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Randomized controlled trial of limited fasciectomy with injection of lipoaspirate adipose graft in the treatment of Dupuytren’s disease

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  • presenting/speaker Marina Tommasini Carrara De Sambuy - Hand and Microsurgery Division, IOT-HCFMUSP, São Paulo, Brazil
  • Hugo Nakamoto - Hand and Microsurgery Division, IOT-HCFMUSP, São Paulo, Brazil
  • Marília Sandalo Trevelin Pimentel - Hand and Microsurgery Division, IOT-HCFMUSP, São Paulo, Brazil
  • Raul Bolliger Neto - Hand and Microsurgery Division, IOT-HCFMUSP, São Paulo, Brazil
  • Maurício Pinto Rodrigues - Hand and Microsurgery Division, IOT-HCFMUSP, São Paulo, Brazil
  • Marcelo Rosa Rezende - Hand and Microsurgery Division, IOT-HCFMUSP, São Paulo, Brazil
  • Teng Hsiang Wei - Hand and Microsurgery Division, IOT-HCFMUSP, São Paulo, Brazil
  • María Virginia Arranz Abreu - Hand and Microsurgery Division, IOT-HCFMUSP, São Paulo, Brazil
  • Rames Jr. Mattar - Hand and Microsurgery Division, IOT-HCFMUSP, São Paulo, Brazil

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-342

doi: 10.3205/19ifssh0482, urn:nbn:de:0183-19ifssh04825

Published: February 6, 2020

© 2020 Tommasini Carrara De Sambuy et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objectives/Interrogation: Dupuytren's disease (DD) is caused by the proliferation and differentiation of myofibroblasts. It is believed that the pluripotent property of stem cells present in adipose tissue would inhibit myofibroblast proliferation. The primary objective of this study was to evaluate the effect of stem cell rich fat graft in patients with DD who underwent limited fasciectomy.

Methods: A total of 45 patients, divided into two groups, were studied in a single blind, prospective and randomized clinical trial. All patients underwent limited fasciectomy. In the control group, only limited fasciectomy was performed. In the fat group, limited fasciectomy was performed and a fat graft was injected at the resected cord site. Outcomes were assessed by Total Passive Extension Deficit (TPED) and Brief Michigan Hand Questionnaire (BMHQ) functional score.

Results and Conclusions: Compared at 6 weeks postoperatively, there was a significant increase in pain in the group with fat graft (p = 0.045). The results of the TPED did not show a significant difference between the groups. The BMHQ had worse outcome measures at 6 months and 1 year postoperatively in the group with fat (p = 0.040 and p = 0.047, respectively). Fat group had 43% complications compared to 8% in the control group (p = 0.019).

The use of fat grafting associated with limited fasciectomy promotes worse functional results compared to conventional limited fasciectomy in the short term. However, there remains doubt as to what the long-term results and recurrence rate will be in the future.