On the treatment of Dupuytren's contraction of the fingers / by James Hardie.

  • Hardie, James, 1841-1909.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of Dupuytren's contraction of the fingers / by James Hardie. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    CONTRACTION OF THE FINGERS. BY JAMES HARDIE, F.R.C.S. By many surgeons the treatment of Dupuytren’s contraction of the fingers is looked upon as highly unsatisfactory, and there is a pretty widespread feeling in the profession generally that it is an affection well nigh incurable. Till recently, I myself have not been sanguine of being able to accomplish much in its treatment, but having, during the present year, operated on several cases according to the method of Goyrand, I am satisfied that the defective results which have so generally been obtained have been due, not so much to any peculiarity in the affection itself, as to erroneous methods of operating. We have, I believe, been led off the track by two causes ; firstly, by the operation introduced by Dupuytren himself, with whose name the affection is so generally associated ; and secondly, by the introduction of subcutaneous surgery. Dupuytren operated* by making transverse incisions through skin and fascia at the most resistant points, a method, undoubtedly, by which the fingers may at once be brought down to a perfectly straight position, if only the incisions be sufficiently numerous and extensive. This result, however, can only be accomplished by the creation of lozenge-shaped gaps in the skin, of a size corresponding to the length of the incisions; and as these gaps have to close subsequently by the process of granu- lation, the ultimate result of such a method must necessarily be a return of the deformity, more or less pronounced, when the natural shrinkage of the granulation tissue has been completed. Possibly, as has been attempted by some, this untoward event might be mitigated by the insertion of sutures, with a view to converting the transverse into a longitudinal wound. But, on account of the peculiar condition of the skin, to be presently alluded to, this is almost impossible; and the attempt is only an expedient to remedy the defects of an operation, as applicable to this condition, erroneous in its very conception. Professor Busch, of Bonn, has recently introduced! a modified method of performing Dupuytren’s operation, by making V-shaped incisions, in order to diminish tho size of the * Lifons orales, Tomo I.