Assessment of hemodynamics of the hand arteries and skin microcirculation in Dupuytren's contracture stages 3 to 4 of before and after surgical treatment with the use of Ilizarov transosseous fixation

Purpose Hemodynamics of the hand arteries and microcirculation of the skin in patients with Dupuytren's contracture in grades 3-4 at the stages of treatment with the use of transosseous fixation was analyzed. Materials and methods Skin microcirculation using laser Doppler flowmetry as well as the microhemodynamics of the arcus palmaris superficialis and the digital arteries using pulse Doppler sonography were studied in 12 patients before surgery and following two to 11 months after the surgery of selective fasciectomy, arthrolysis and transosseous fixation. The state of the arteries of the palmar aponeurosis was verified histologically using light microscopy of paraffin sections of the surgical material. Results Before surgery, seven out of 12 patients had vasoconstriction of the digital arteries on the ulnar side of the hand and the palmar arch. Histologically, the arteries of the palmar aponeurosis were of small caliber (four or less layers of smooth muscle cells in the media) with signs of muscle hyperplasia and remodeling of the elastic membrane; larger arteries featured damage to the internal elastic membrane and neointimal thickening...