The continuous elongation treatment by the TEC device for severe Dupuytren's contracture of the fingers.

Abstract

The continuous elongation technique is a preparatory step for excision of the pathologic palmar fascia for severe Dupuytren's contracture of the hands. It consists of a physiologic, painless, and atraumatic elongation that is obtained by means of a device fixed on the fourth and fifth metacarpal bones by two self-drilling pins. This paper presents our experience since 1986 with the TEC device, which we designed and built for severe hand contracture; the device has been applied on 56 hands and 85 fingers seriously flexed by Dupuytren's contracture. This advanced methodology also represents a real alternative to the surgical indication of finger amputation in progressive cases of the fascia retraction, and it avoids the necrosis, loss of vascularity, and bad functional results frequently seen after classical operations. The TEC device also avoids the plastic surgical correction of digital or palmar skin loss, particularly when there is a need for a flap or a skin graft. Dupuytren's contracture was for 160 years thought to be degenerative, progressive, and irreversible, but the TEC device, by bringing the contracture back to the initial stage of the disease, opens up new basic research into morphologic and biochemical processes of the collagen in the retracted palmar fascia.