13. Segmental aponeurectomy: exceptions
As we have seen in the previous chapter, there were 14 cases in which a segmental aponeurectomy was planned but could not be carried out because there was too much skin shortage or because the dissection of the neurovascular pedicles was considered as being too risky.
This chapter will analyse the differences between these cases and those which could be operated as planned.
13.1 The patients
The characteristics of these patients were in many respects different from those operated as planned by segmental aponeurectomy (statistical methodology: Pearson's Chi-square test and Student's t-test). They are summarised in tables 1 and 2.
Table 13-1
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Table 13-2
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Although there are only 14 cases, the proportions are expressed as percentages to make the comparison easier. As can be seen, the patients of this group are younger and almost half of them had already been operated before. Only 5 of them (35.7 %) had no personal history compared with 72.9 % in the "normal" group.
13.2 Hand condition
The hand condition of these patients was also much worse as can be seen from table 3: they had more extension deficit and more impairment of function (statistical methodology: Mann-Whitney test).
Table 13-3: Comparison of hand condition
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13.3 Discussion
The patients for whom a segmental aponeurectomy was planned but could not be carried out because of local difficulties are clearly different and their disease is more aggressive and widespread.
However, with the selection criteria used today, a segmental aponeurectomy would never have been planned for six of them because of their previous operation.