The causes and operative treatment of Dupuytren's finger contraction / by Otto W. Madelung ; translated from the German.

  • Madelung, Otto Wilhelm, 1846-1926.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: The causes and operative treatment of Dupuytren's finger contraction / by Otto W. Madelung ; translated from the German. 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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    I therefore believe that I am justified in advising patients who cannot be operated on according to Busch’s method, to desist from any other treatment, however innocent it may appear. We have had repeated calls from patients, as may he imagined, whose fingers were not contracted to such an extent as to make an operation necessary. They were advised not to attempt any manual or mechanical means of extension, but to avoid, in so far as this was possible, all acts requiring strong efforts of the fingers, and to give up such mechanical occupations as expose the palm of the hand to the pressure of tools and the like. Whether this advice has protracted the suffering of our patients I cannot say, as the time that has elapsed since it was given has been too short to permit of an opinion being formed. In any case, the observation already mentioned, that any further contraction of the fingers ceases as soon as the disease has reached such a height that ordinary occupations have to be abandoned, seems to support this expectative method of treatment. And here I say again that I have constantly seen the opera- tive treatment by Busch’s method crowned with the most brilliant success. In some of the slighter cases the cure was effected by a single operation, and without difficulty. The patient, whose case is mentioned on page 13, made up his mind to submit to a second operation for the relief of a contraction of the second phalanx of the little finger, which had taken place since he had been under treatment before. On the 6th December 1875, accordingly, the fibrous bands which impeded motion were divided, and the first phalanx straightened. The operation consisted in the detachment of a triangular flap of skin, the basis of which was in the furrow of the first phalangeal articulation and the apex at the ulnar end of the furrow, which marked the metacarpo-phalangeal articulation. This patient left the hospital as early as the 18th of the same month cured. The success of the operation is perhaps better vouched for by what the patient himself has written to me on the subject, than it would be by my medical report and verdict. “ Before the last operation,” he says, “ I could hardly touch