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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    an octave on the piano, and could not read) a sixth with the fore and little fingers at all. At present I easily touch a ninth, and nearly reach a tenth. The following chords, which I could not formerly strike at all, are now quite easy :— Chords. But the operation in the cases mentioned above, in which th disease of the fascia extended over a wider area of the palm of the hand, was surgically more interesting than in this and in other cases where one or two fingers only were contracted. Two patients of this kind came to the hospital. In the one, the middle and ring fingers of the right hand wrere completely flexed, the fore and little fingers being also affected to a moderate degree, whilst the thumb was drawn in towards the palm, without contraction of the phalanges. In the left hand, again, the little finger was completely bent, the ring-finger moderately so, and the middle one more slightly. In the case of the second patient, the fore and ring fingers of the right hand were completely bent. Of the left hand, the little finger was also completely bent. The thumb was so much drawn in towards the middle of the palm, that its only possible motion was between the first and second phalanges. In these two cases not only was the fascia of the palm of the hand, but the fibrous tissues of the inside of all the fingers were also diseased in a high degree. These complicated cases, such as had not even been treated before at Bonn, demonstrate more particularly the propriety of attending to what is said on page 11, namely, that too much should not be attempted in the way of operation at once. Patients labouring under such extensive affections of the hands should be prepared, before any operation is attempted, to understand that it is uuadvisable to attempt accomplishing everything at once, or by a single operation. One point which I should more particularly insist on is this, that no attempt should bo made to stretch and straighten the crooked