A Clinical Grading System for Dupuytren’s Contracture

1998 ◽  
Vol 23 (3) ◽  
pp. 303-305 ◽  
Author(s):  
M. J. WOODRUFF ◽  
M. A. WALDRAM
Keyword(s):  
Operation Time ◽  
Dupuytren’S Contracture ◽  
Clinical Classification ◽  
Surgical Experience ◽  
Broad Agreement ◽  
Dupuytren's Contracture ◽  
Actual Operating ◽  
Significant Difference ◽  
The Individual ◽  
Clinical Grading

A clinical classification for Dupuytren’s contracture of the hand is described. The classification system has been used to sort patients with Dupuytren’s contracture into five broad surgical categories and takes into account predisposing factors, risk of recurrence and sympathetic tone in the individual patient. The system has many advantages in determining the approximate operation time and surgical experience required to treat patients. One hundred and four patients graded by this system have been analysed. There was a broad agreement between expected and actual operating times, with no significant difference between them.

Percutaneous needle fasciotomy for primary Dupuytren’s contracture

2011 ◽  
Vol 36 (7) ◽  
pp. 548-552 ◽  
Author(s):  
L. Rahr ◽  
P. Søndergaard ◽  
T. Bisgaard ◽  
T. Baad-Hansen
Keyword(s):  
Open Surgery ◽  
Tendon Rupture ◽  
Sensory Nerves ◽  
Dupuytren’S Contracture ◽  
Extension Deficit ◽  
Joint Contractures ◽  
Dupuytren's Contracture ◽  
Rehabilitation Period ◽  
Severe Comorbidity ◽  
The Individual

This study evaluated the effect of percutaneous needle fasciotomy on primary Dupuytren’s contracture in 149 patients (213 rays) admitted to our clinic in 2007. Ninety-two patients (130 rays) were followed up for 2 years to compare the change in total passive extension deficit and the passive extension deficit across the individual joint and to note side effects. No tendon rupture or damage to sensory nerves was observed and the rehabilitation period was short (mean, 0.6 days). We found a significant change ( p < 0.001) in total passive extension deficit after 2 years, but the effect of the treatment was greater in Tubiana I and II stages and our best results were in correction of MCP joint contractures. Percutaneous needle fasciotomy is an alternative treatment for elderly patients with severe comorbidity or for those patients who do not want open surgery.

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.

A prospective randomised trial of absorbable versus non-absorbable sutures for wound closure after fasciectomy for Dupuytren’s contracture

2009 ◽  
Vol 34 (5) ◽  
pp. 618-620 ◽  
Author(s):  
K. HOWARD ◽  
A. J. M. SIMISON ◽  
A. MORRIS ◽  
V. BHALAIK
Keyword(s):  
Wound Closure ◽  
Wound Care ◽  
Randomised Trial ◽  
Dupuytren’S Contracture ◽  
Polyglactin 910 ◽  
Randomised Study ◽  
Dupuytren's Contracture ◽  
Prospective Randomised Trial ◽  
Absorbable Sutures ◽  
Significant Difference

After fasciectomy for Dupuytren’s contracture the wound has traditionally been closed with non-absorbable sutures. A prospective randomised study of 59 patients was undertaken to compare wound closure after fasciectomy with irradiated polyglactin 910 absorbable sutures and non-absorbable sutures. The outcomes studied were: time spent attending to the wound at the first postoperative visit; the patient’s pain score at that visit; and any complications. Wound care required significantly more time when non-absorbable sutures were used. There was no significant difference in pain scores or in complications between the two groups. We recommend the use of irradiated polyglactin 910 absorbable sutures for wound closure after fasciectomy as it saves time and resources without compromising wound healing.

Percutaneous Needle Fasciotomy versus Collagenase Injection for Dupuytren’s Contracture: A Systematic Review of Comparative Studies

2020 ◽  
Author(s):  
Takashi Hirase ◽  
Rishi Suresh ◽  
Michael O. Cotton ◽  
Alex Han ◽  
Matthew B. Burn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Randomized Study ◽  
Dupuytren’S Contracture ◽  
Complication Rates ◽  
Dupuytren's Contracture ◽  
Level Ii ◽  
Significant Difference ◽  
Collagenase Injection ◽  
Level I

Abstract Introduction The purpose of this study was to review and compare clinical outcomes between percutaneous needle fasciotomy (PNF) and collagenase Clostridium histolyticum (CCH) injection for the treatment of Dupuytren’s contracture. Materials and Methods A systematic review was performed including all level I-III evidence studies investigating the clinical outcomes of PNF and CCH injection in the treatment of Dupuytren’s contracture. Results Five studies (278 CCH patients, 225 PNF patients; 285 CCH fingers, 246 PNF fingers, 405 males, and 98 females) were analyzed. Two randomized studies were level I evidence, one randomized study was level II, and two nonrandomized studies were level III. Two studies analyzed a total of 205 patients, each demonstrating statistically superior outcomes in one outcome measure (contracture improvement and Michigan Hand Questionnaire (MHQ) satisfaction subscore) with PNF, while the remaining three studies demonstrated no significant differences in outcomes between the two techniques. Three studies reported a statistically higher rate of minor complications (local pain, edema, ecchymosis, lymphadenopathy, pruritis) with CCH, while the remaining two studies demonstrated no significant difference in complication rates. Conclusion For the treatment of Dupuytren’s contracture, there is some evidence that suggests superior clinical outcomes of PNF compared with CCH and a higher minor complication rate with CCH.

THE PROGNOSIS OF FASCIECTOMY FOR ABDUCTOR DIGITI MINIMI AND PRETENDINOUS CORDS IN DUPUYTREN'S DISEASE OF THE LITTLE FINGER

Hand Surgery ◽  
2009 ◽  
Vol 14 (02n03) ◽  
pp. 89-92 ◽  
Author(s):  
M. J. Walton ◽  
D. Pearson ◽  
D. A. Clark ◽  
R. K. Bhatia
Keyword(s):  
Dupuytren’S Disease ◽  
Dupuytren’S Contracture ◽  
Residual Deformity ◽  
Dupuytren's Disease ◽  
Dupuytren's Contracture ◽  
Significant Difference ◽  
Abductor Digiti Minimi ◽  
The Mean ◽  
Recurrent Deformity ◽  
Little Finger

Thirty-nine consecutive patients with little finger Dupuytren's contracture underwent open fasciectomy. Diseased abductor digiti minimi (ADM) pretendinous (PT) cords were identified. The mean pre-operative PIPJ contracture was 77° in the PT group and 66° in the ADM group. Mean residual deformity was 12° in the PT group and 9° in the ADM group. At six months, ten out of 27 patients had developed a recurrent deformity in the PT group (mean 24°) and seven out of 11 in the ADM group (mean 18°). There was no statistically significant difference between the two groups at any stage. Dupuytren's contracture of the little finger is as a result of an ADM cord in 29% of cases. In this series it led to an isolated contracture of the PIPJ in the majority of cases and rarely affected the MCPJ. Disease of the ADM cord was not associated with a difference in contracture or prognosis compared to a PT cord.

Dupuytren's Contracture and Microvessels

1981 ◽  
Vol 39 ◽  
pp. 470-471
Author(s):  
C. W. Klscher ◽  
D. Speer
Keyword(s):  
Hypertrophic Scar ◽  
Active Form ◽  
Scar Tissue ◽  
Vascular Supply ◽  
Fiber Bundles ◽  
Dupuytren’S Contracture ◽  
Palmar Fascia ◽  
Immune Disease ◽  
Dupuytren's Contracture ◽  
Longitudinal Fiber

Dupuytren's Contracture is a nodular proliferation of the longitudinal fiber bundles of palmar fascia with its attendant contraction. The factors attributed to its etiology have included trauma, diabetes, alcoholism, arthritis, and auto-immune disease. The tissue has been observed by electron microscopy and found to contain myofibroblasts.Dupuytren's Contracture constitutes a scar, and as such, excessive collagen can be observed, along with an active form of fibroblast.Previous studies of the hypertrophic scar have led us to propose that integral in the initiation and sustenance of scar tissue is a profusion of microvascular regeneration, much of which becomes and remains occluded producing a hypoxia which stimulates fibroblast synthesis. Thus, when considering a study of Dupuytren's Contracture, we predicted finding occluded microvessels at or near the fascial scarring focus.Three cases of Dupuytren's Contracture yielded similar specimens, which were fixed in Karnovskys fluid for 2 to 20 days. Upon removal of the contracture bands care was taken to include the contiguous fatty and areolar tissue which contain the vascular supply and to identify the junctional area between old and new fascia.

Writing in Aphasia Rehabilitation: Cursive vs Manuscript

1976 ◽  
Vol 41 (4) ◽  
pp. 523-529 ◽  
Author(s):  
Daniel R. Boone ◽  
Harold M. Friedman
Keyword(s):  
Correct Response ◽  
The Other ◽  
Read Aloud ◽  
Writing Style ◽  
Reading And Writing ◽  
Manual Responses ◽  
Significant Difference ◽  
Written Form ◽  
The Individual ◽  
Read Number

Reading and writing performance was observed in 30 adult aphasic patients to determine whether there was a significant difference when stimuli and manual responses were varied in the written form: cursive versus manuscript. Patients were asked to read aloud 10 words written cursively and 10 words written in manuscript form. They were then asked to write on dictation 10 word responses using cursive writing and 10 words using manuscript writing. Number of words correctly read, number of words correctly written, and number of letters correctly written in the proper sequence were tallied for both cursive and manuscript writing tasks for each patient. Results indicated no significant difference in correct response between cursive and manuscript writing style for these aphasic patients as a group; however, it was noted that individual patients varied widely in their success using one writing form over the other. It appeared that since neither writing form showed better facilitation of performance, the writing style used should be determined according to the individual patient’s own preference and best performance.

Aftermath Effect Of GST On Consumer Purchasing Power

2019 ◽  
Vol 118 (5) ◽  
pp. 122-131
Author(s):  
S. Thowseaf ◽  
M. Ayisha Millath ◽  
K. Malik Ali
Keyword(s):  
Living Standard ◽  
Purchasing Power ◽  
Percentage Increase ◽  
Defense System ◽  
Key Factors ◽  
Predominant Role ◽  
Tax System ◽  
Significant Difference ◽  
The Individual ◽  
Taxation System

Tax is an important source of income for the country. It is through tax; country strengthens its defense system, infrastructure, and government. Hence, tax system plays a predominant role in developing country’s economy. The complication in taxation system and liberty for taxpayers are key factors generating loopholes for corruption. GST is superior taxation system over VAT but, if neither properly implemented nor scrutinized according to the economy, it is people residing get affected.  GST taxation system is capable of increasing legal transaction, reducing corruption and complexity that exists in current taxation. India is 166th country to adopt GST and GST taxation slab in India is 0%, 5%, 12%, 18% and 28%.  Although average Tax levied is 14.8750% in India, it is 28% tax that is levied for most of the commodities, which are directly or indirectly used in everyday life of common individuals. Despite, GST being favorable to distributor in-terms of profit and government to attain tax by increasing legal transaction through invoice. It is noted that for the same percentage of taxation, the amount does not vary for VAT and GST. The tax slab decreased for 71 commodities and no change in 21 commodities; there has been an increase in tax slab for 60 commodities. 26% taxation was levied for most commodities considered was currently levied by 28% taxation which is greater than before. It was found that average tax percentage reduced was calculated to be 6.07143. The average tax percentage increase was calculated to be 4.7833 percentage for the considered commodities. The overall tax average tax percentage is estimated to be 14.8750% which does not have a significant difference concerning tax levied before GST, which was calculated to be 15.7829% for considered commodities. Therefore, the consumer purchasing power and overall living standard of the individual in India will remain almost same.

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