Dupuytren’s disease

2011 ◽  
Author(s):  
Peter Burge
Keyword(s):  
Surgical Treatment ◽  
Steroid Injection ◽  
Treatment Options ◽  
Genetic Component ◽  
Dupuytren’S Disease ◽  
Palmar Fascia ◽  
Dupuytren's Disease ◽  
Collagenase Injection ◽  
Operative Complications ◽  
Non Surgical Treatment

♦ Dupuytren’s disease is characterised by contracture of a finger resulting from thickening and shortening of the palmar fascia♦ A genetic component to the aetiology is apparent, smoking, alcohol and diabetes can increase the risk♦ The pathogenesis of Dupuytren’s disease remains elusive♦ Non-surgical treatment options include splintage, steroid injection and collagenase injection♦ Surgery cannot cure the disease but can straighten bent digits and minimize recurrence♦ Operative methods can be considered with regards to incision, management of the diseased fascia and closure techniques♦ Operative complications include injury of digital nerves and arteries

scholarly journals Emerging Concept of Dupuytren’s Disease

2021 ◽  
Vol 6 (4) ◽  
pp. 278-285
Author(s):  
Putu Feryawan Meregawa ◽  
John Nolan
Keyword(s):  
Inflammatory Response ◽  
Treatment Options ◽  
Dupuytren’S Disease ◽  
Palmar Fascia ◽  
Post Intervention ◽  
Dupuytren's Disease ◽  
Clostridium Histolyticum ◽  
Major Factors ◽  
High Possibility ◽  
Non Surgical Treatment

Dupuytren’s disease is a disorder of fibroproliferative condition causing thickened and contracted of the palmar fascia. The pathophysiology behind this disease is complex and multifactorial. Some major factors are genetic predisposition, inflammatory response, trauma, comorbidities, and environmental factors. The treatment options for Dupuytren’s disease are divided into non-surgical and surgical management. Needle fasciotomy and fasciectomy are some of the most common surgical procedures chosen. Novel non-surgical treatment option as the recent advance in the treatment of the disease is the injection of collagenase Clostridium histolyticum (CCH). One of the pitfalls of Dupuytren’s management is the high possibility of the disease’s recurrence along with some other post-intervention complications. Rehabilitation following the interventions is needed to manage the maximum range of motion and curtail the inflammatory response after the cord disruption. Keywords: Dupuytren’s disease, clostridium histolyticum, fasciectomy.

The Use of Splinting as a Non-Surgical Treatment for Dupuytren's Disease: A Pilot Study

2002 ◽  
Vol 7 (3) ◽  
pp. 76-78 ◽  
Author(s):  
Cathy Ball ◽  
Jagdeep Nanchahal
Keyword(s):  
Surgical Treatment ◽  
Pilot Study ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Preliminary Study ◽  
Proliferative Disease ◽  
Non Surgical Treatment

A preliminary study of six patients with Dupuytren's disease treated with external night splintage has demonstrated a reduction in digital contractures without loss of composite flexion. The greatest benefit was noted in patients with early, proliferative disease and was dependent on compliance with the splintage.

scholarly journals Recent Surgical and Medical Advances in the Treatment of Dupuytren’s Disease - A Systematic Review of the Literature

2012 ◽  
Vol 6 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Mafi R ◽  
Hindocha S ◽  
Khan W
Keyword(s):  
Treatment Options ◽  
Fibrous Tissue ◽  
Dupuytren’S Disease ◽  
Inclusion Criteria ◽  
Palmar Fascia ◽  
Dupuytren's Disease ◽  
Medical Interventions ◽  
Shockwave Therapy ◽  
Medical Advances ◽  
Needle Aponeurotomy

Dupuytren’s disease (DD) is a type of fibromatosis which progressively results in the shortening and thickening of the fibrous tissue of the palmar fascia. This condition which predominantly affects white-northern Europeans has been identified since 1614. DD can affect certain activities of daily living such as face washing, combing hair and putting hand in a glove. The origin of Dupuytren’s contracture is still unknown, but there are a number of treatments that doctors have come across throughout the years. Historically surgery has been the mainstay treatment for DD but not the only one. The objective is to make a structured review of the most recent advances in treatment of DD including the surgical and medical interventions. We have looked at the most relevant published articles regarding the various treatment options for DD. This review has taken 55 articles into consideration which have met the inclusion criteria. The most recent treatments used are multi-needle aponeurotomy, extensive percutaneous aponeurotomy and lipografting, injecting collagenase Clostridium histolyticum, INF-gamma and shockwave therapy as well as radiotherapy. Each of these treatments has certain advantages and drawbacks and cannot be used for every patient. In order to prevent this condition, spending more time and money in the topic is required to reach better and more consistent treatments and ultimately to eradicate this disease.

scholarly journals An effectiveness evaluation of the palmar fascia irradiation of patients suffering from Dupuytren’s disease

2017 ◽  
Vol 67 (3) ◽  
pp. 162-167 ◽  
Author(s):  
Tomasz Latusek ◽  
Leszek Miszczyk ◽  
Grzegorz Gierlach ◽  
Piotr Zając
Keyword(s):  
Dupuytren’S Disease ◽  
Effectiveness Evaluation ◽  
Palmar Fascia ◽  
Dupuytren's Disease

Dupuytren's Disease: An Outcomes-Focused Update

2021 ◽  
Author(s):  
Yasser H. Almadani ◽  
Joshua Vorstenbosch ◽  
Johnny Ionut Efanov ◽  
Liqin Xu
Keyword(s):  
Patient Education ◽  
Genetic Predisposition ◽  
Treatment Options ◽  
Clinical Treatment ◽  
Dupuytren’S Disease ◽  
Treatment Modalities ◽  
Recurrence Rates ◽  
Dupuytren's Disease ◽  
Associated Factor ◽  
Informed Decisions

AbstractDupuytren's disease (DD) remains a common fibroproliferative condition with significant sequelae and impact on patient's lives. The etiology of DD is poorly understood, and genetic predisposition is thought to be a strongly associated factor. Despite remarkable strides in improving our molecular understanding of DD, clinical treatment options have not yet overcome the frequently encountered challenge of recurrence. Recurrence rates continue to shape the prognosis of this fibrotic condition. In this outcomes-focused article, the various treatment modalities are reviewed. This further emphasizes the importance of patient education and providing them with the information to make informed decisions about their treatment.

scholarly journals Dupuytren'S Contracture; Increased Cellularity — Proliferation, is There Equality?

2005 ◽  
Vol 94 (1) ◽  
pp. 71-75
Author(s):  
M. Forsman ◽  
L. Kallioinen ◽  
M. Kallioinen ◽  
J. Ryhänen
Keyword(s):  
Inflammatory Process ◽  
Dupuytren’S Disease ◽  
Palmar Fascia ◽  
Ki 67 ◽  
Dupuytren's Disease ◽  
Chronic Inflammatory Process ◽  
Proliferative Phase ◽  
Palmar Aponeurosis ◽  
Histological Characteristics ◽  
Control Samples

Background: Dupuytren's disease is a chronic inflammatory process which causes contractures of the fingers by shortening and thickening the palmar fascia. During the proliferative phase, fibroblasts transform into myofibroblasts apparently under the influence of several different factors. The disease usually develops slowly, but in some patients it tends to develop aggressively. The pathogenesis of Dupuytren's disease remains unsolved. In this study, we analyzed some histological characteristics that seem to predict rapid recurrence. Material and Methods: 21 patients were divided into two groups. In 11 patients the disease was classified as aggressive because it had recurred within two years after an operation. In 10 cases it was non-aggressive, as no recurrence had been seen. Five control samples were taken from healthy palmar aponeurosis. The differences in cellularity, collagen, Ki-67, MSA, alpha-SMA and tenascin between the specimens were analyzed using immunohistochemistry. Results: Alpha-SMA and Ki-67 were present more often in the aggressive specimens. Immunohistochemical stainings for macrophages and lymphocytes were negative. Conclusion: There may be differences in the histology and/or immunohistochemical appearance of pathological palmar connective tissue cords in aggressive and normal Dupuytren's disease. Further studies are needed to elucidate the pathogenesis of this disease.

scholarly journals Periostin differentially induces proliferation, contraction and apoptosis of primary Dupuytren's disease and adjacent palmar fascia cells

2009 ◽  
Vol 315 (20) ◽  
pp. 3574-3586 ◽  
Author(s):  
Linda Vi ◽  
Lucy Feng ◽  
Rebecca D. Zhu ◽  
Yan Wu ◽  
Latha Satish ◽  
...  
Keyword(s):  
Dupuytren’S Disease ◽  
Palmar Fascia ◽  
Dupuytren's Disease

THE McCASH TECHNIQUE FOR DUPUYTREN'S DISEASE: OUR EXPERIENCE

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 61-67 ◽  
Author(s):  
Aristides B. Zoubos ◽  
Nikolaos A. Stavropoulos ◽  
George C. Babis ◽  
Andreas F. Mavrogenis ◽  
Zinon T. Kokkalis ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Sensory Evaluation ◽  
Rehabilitation Program ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Bilateral Involvement ◽  
Pip Joint ◽  
The Mean ◽  
Acceptable Outcome

This study presents the clinical outcomes of 35 hands with Dupuytren's Disease treated with the McCash technique between 1990 and 2009. Of the 31 patients (28 males and three females, mean age 53 yrs), four patients had bilateral involvement (12.9%). Thirty hands had no previous medical or surgical treatment for the disease, while the remaining five hands had been operated on at least once. The mean contracture of metacarpophalangeal (MCP) joint improved from 42.14° to 1.83°, while that of the proximal interphalangeal (PIP) joint improved from 62.60° to 7.09°. All wounds healed within a mean 9.8 weeks. Sensory evaluation revealed no permanent numbness. With realistic expectations, clear documentation, meticulous surgical technique and implementation of a demanding post-operative rehabilitation program, an acceptable outcome may be achieved with the McCash technique for Dupuytren's disease.

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