Assessment of Percutaneous Fasciotomy in the Management of Dupuytren’s Contracture

1984 ◽  
Vol 9 (2) ◽  
pp. 163-164 ◽  
Author(s):  
D. I. ROWLEY ◽  
M. COUCH ◽  
R. B. CHESNEY ◽  
S. H. NORRIS
Keyword(s):  
Prospective Study ◽  
Metacarpophalangeal Joint ◽  
Dupuytren’S Contracture ◽  
Dupuytren's Contracture

This prospective study of the treatment of Dupuytren’s Contracture in 78 hands has been designed to investigate the role of subcutaneous fasciotomy. The results suggest that in hands where the contracture is predominantly at the metacarpophalangeal joint, then percutaneous fasciotomy is of value.

An Investigation into the Role of Inflammatory Cells in Dupuytren’s Disease

1991 ◽  
Vol 16 (3) ◽  
pp. 267-271 ◽  
Author(s):  
J. G. ANDREW ◽  
S. M. ANDREW ◽  
A. ASH ◽  
B. TURNER
Keyword(s):  
Inflammatory Cells ◽  
Dupuytren’S Disease ◽  
Dupuytren’S Contracture ◽  
Palmar Fascia ◽  
Dupuytren's Disease ◽  
Dupuytren's Contracture ◽  
Microvascular Changes ◽  
Macrophage Marker ◽  
Fibrotic Diseases

An immunohistochemical study was performed on nodules excised from the palmar fascia of patients with Dupuytren’s contracture. In cellular nodules, antibodies to actin (used as a marker for myofibroblasts), desmin, vimentin, Mac 387 (a macrophage marker) and leucocyte common antigen were used. A correlation was demonstrated between the numbers of macrophages and the presence of myofibroblasts. The presence of myofibroblasts is generally considered to indicate the active stage of the disease. Inflammatory cells other than macrophages were largely absent from the nodules, although lymphocytes were frequent in the tissue around the nodules. Microvascular changes were prominent in the nodules and pericyte proliferation was observed around occluded capillaries. Release of growth factors from macrophages may be important in Dupuytren’s contracture, as is the case in other fibrotic diseases. The possible role of macrophages in the aetiology of Dupuytren’s disease is discussed.

Effect of Oral Prednisolone after Collagenase Injection for Dupuytren’s Contracture: A Randomized, Controlled Trial with a 1-Year Follow-Up

2020 ◽  
Author(s):  
Yoshihiro Abe
Keyword(s):  
Controlled Trial ◽  
Oral Prednisolone ◽  
Metacarpophalangeal Joint ◽  
Control Group ◽  
Dupuytren’S Contracture ◽  
Active Motion ◽  
Dupuytren's Contracture ◽  
Significant Difference ◽  
Total Active Motion

Abstract Introduction This study verified the effectiveness of oral prednisolone after collagenase clostridium histolyticum (CCH) (10 mg/day for 2 weeks) for Dupuytren’s contracture with a 1-year follow-up. Materials and Methods This study included 31 patients with a contracture of the metacarpophalangeal joint of ≥ 30 degrees. A total of 16 patients were allocated randomly to treatment with prednisolone and 15 patients were treated without prednisolone (control group). Results At day 7, mean total active motion (TAM) was 235 degrees in the prednisolone group and 228 degrees in the control group. Mean Visual Analog Scale was 3.3 in the prednisolone group and 4.6 in the control group. There was significant difference between two groups. At day 30, mean TAM was 241 degrees in the prednisolone group and 233 degrees in the control group. There were significant difference between two groups The mean QuickDASH score was significantly higher in the control group (5.8 vs. 3.4). Recurrence was observed in 2/16 patients (13%) in the prednisolone group and 5/15 patients (33%) in the control group; there was no significant difference. Conclusion The administration of prednisolone decreased the likelihood of adverse effects, and also improved finger flexion range of motion and reduced pain after CCH.

Ultrasonographic examination of the ruptured cord after collagenase treatment or needle fasciotomy for Dupuytren’s contracture

2017 ◽  
Vol 42 (7) ◽  
pp. 683-688 ◽  
Author(s):  
J. Strömberg ◽  
P. Vanek ◽  
J. Fridén ◽  
Y. Aurell
Keyword(s):  
Local Treatment ◽  
Metacarpophalangeal Joint ◽  
Dupuytren’S Contracture ◽  
Joint Movement ◽  
Level Of Evidence ◽  
Dupuytren's Contracture ◽  
Collagenase Treatment ◽  
Before And After ◽  
The Difference ◽  
Ultrasonographic Appearance

Local treatment of Dupuytren’s contracture, either by collagenase or needle fasciotomy, allows disruption of the pathological cord during forced extension. The purpose of this study was to investigate the cord before and after both treatments by ultrasound. A total of 39 patients with a minimum of 20° contracture in the metacarpophalangeal joint were included and randomized to treatment with either collagenase (20 patients) or needle fasciotomy (19 patients). The distance between the distal and the proximal parts of the ruptured cord was measured by ultrasound and the difference in passive joint movement before and after treatment was measured with a goniomenter. There were no significant differences between the collagenase and needle fasciotomy groups in the size of the rupture or gain of mobility. Most cords treated with collagenase and subsequent forced extension had the same ultrasonographic appearance as cords disrupted mechanically by needle fasciotomy. Level of evidence: III

Dupuytren's Contracture—The Role of Fasciotomy

HAND ◽  
1983 ◽  
Vol os-15 (2) ◽  
pp. 162-166 ◽  
Author(s):  
J. Colville
Keyword(s):  
Operative Technique ◽  
Dupuytren’S Contracture ◽  
Dupuytren's Contracture

This paper summarises the results obtained in 95 patients treated by fasciotomy, defines the indications for this procedure and describes the operative technique. During a period of seven years a total of 95 patients with 137 fingers affected by Dupuytren's Contracture have been treated by fasciotomy. The minimum follow-up is two years. The oldest patient was 79 years and no patient younger that 50 years was accepted for this form of treatment.

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