Observations on contraction of the fingers (Dupuytren's contraction) : and its successful treatment by subcutaneous divisions of the palmar fascia, and immediate extension also on the obliteration of depressed cicatrices after glandular abcesses, or exfoliation of bone by a subcutaneous operation / by William Adams.

  • Adams, William, 1810-1900.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Observations on contraction of the fingers (Dupuytren's contraction) : and its successful treatment by subcutaneous divisions of the palmar fascia, and immediate extension also on the obliteration of depressed cicatrices after glandular abcesses, or exfoliation of bone by a subcutaneous operation / by William Adams. Source: Wellcome Collection.

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    harm. I think, then, I shall operate, as I have done before, by dh^ect incisions through the skin and sub- jacent contracted portions of fascia. It is true, there will then be several suppurating wounds, a little lint being put between the edges of the incisions to prevent their union; but then, on the other hand, there will be no confinement of matter, and conse- quently no probability that the suppuration will extend itself beyond the small cuts themselves, which extension is much more dangerous than the open- wounds can be. It does not appear that Dupuytren met with any mischief when he did the operation in this way, and when I have done it myself, there was no inflammation of any importance produced. It will thus be seen that this accomplished English surgeon thirty-five years ago foreshadowed the subcu- taneous operation recommended at present for its relief, and accurately indicated the spot at which the fascial band, or bands, in the palm of the hand, and also the digital prolongations of the palmar fascia should be divided. The danger of deep suppuration, however, outweighed, in Mr. Hawkins' opinion, the supposed advantages of the subcutaneous operation. He followed Dupuytren, and preferred performing the operation by open-wound. In explanation of this decision, it must be remem- bered that subcutaneous surgery was at this time in its infancy, and the law upon which the safety of subcuta- neous operations depend was not fully recognized. Subcutaneous tenotomy, as improved and performed by Stromeyer in 1831, was introduced into England in the year 1837, by Dr. Little, who had been operated upon by Stromeyer, in the previous year.