scholarly journals Management of Dupuytren's Disease – Clear Advice for an Elusive Condition

2006 ◽  
Vol 88 (1) ◽  
pp. 3-8 ◽  
Author(s):  
A Bayat ◽  
DA McGrouther
Keyword(s):  
Age Of Onset ◽  
Positive Family History ◽  
Significant Risk ◽  
Unknown Origin ◽  
Postoperative Recovery ◽  
Flexion Contracture ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Functional Benefit ◽  
Soles Of The Feet

Dupuytren's disease is a progressive fibroproliferative disorder of an unknown origin affecting the hands causing permanent flexion contracture of the digits. Significant risk factors for development of Dupuytren's disease include old age, male sex, white northern European extraction, presence of positive family history of Dupuytren's disease, and diabetes mellitus. The disease also seems to deteriorate rapidly in those cases showing young age of onset and additional fibromatosis affecting the back of the hands, soles of the feet and the penis. Although there is no cure, patients with Dupuytren's disease of the hand may gain a significant functional benefit following surgical improvement or correction of the deformity. With realistic expectations, timely and appropriate surgical technique in a specialist centre, and attention to postoperative recovery and rehabilitation (occupational therapy and physiotherapy support), a beneficial outcome can be achieved in most cases.

Cleland’s ligaments and Dupuytren’s disease

2013 ◽  
Vol 39 (5) ◽  
pp. 477-481 ◽  
Author(s):  
D. J. Shewring ◽  
U. Rethnam
Keyword(s):  
Histological Analysis ◽  
Residual Disease ◽  
Flexion Contracture ◽  
Joint Contracture ◽  
Dupuytren’S Disease ◽  
Histological Findings ◽  
Dupuytren's Disease ◽  
Pip Joint ◽  
Joint Flexion ◽  
Neurovascular Bundles

The aim of this study was to investigate whether Cleland’s ligaments are affected by Dupuytren’s disease and assess their contribution to the flexion contracture of the proximal interphalangeal (PIP) joint. Twenty patients with Dupuytren’s disease undergoing fasciectomy for a PIP joint contracture > 40° (mean 61°, range 45°–100°) were included. After excision of all other identifiable digital disease, Cleland’s ligaments were assessed. If they appeared to be macroscopically affected by Dupuytren’s disease they were excised, sent for histological analysis, and any further improvement of PIP joint contracture was recorded. There were 14 males and six females with a mean age of 62 (range 40–79) years. Excision of Cleland’s ligaments resulted in a mean further correction of 7° (range 0°–15°). Histological analysis indicated that Cleland’s ligament was clearly involved with Dupuytren’s disease in 12 patients, indicating that Cleland’s ligaments can be affected by Dupuytren’s disease. In the remaining specimens the histological findings were equivocal. As these structures are situated dorsal to the neurovascular bundles, a specific dissection has to be undertaken to identify them. Excision of Cleland’s ligaments at digital fasciectomy further avoids leaving residual disease and may yield a worthwhile further correction of PIP joint flexion contracture.

scholarly journals Finger shortening for Dupuytren’s disease-induced severe PIP joint flexion contracture of the little finger: A report of two cases

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 11
Author(s):  
Yoko Ito ◽  
Kiyohito Naito ◽  
Nana Nagura ◽  
Yoichi Sugiyama ◽  
Hiroyuki Obata ◽  
...  
Keyword(s):  
Daily Living ◽  
Treatment Method ◽  
Flexion Contracture ◽  
Dupuytren’S Disease ◽  
High Patient Satisfaction ◽  
Dupuytren's Disease ◽  
Extended Position ◽  
Pip Joint ◽  
Joint Flexion ◽  
Little Finger

When severe proximal interphalangeal (PIP) joint flexion contracture is induced in the little finger by Dupuytren’s disease, it interferes with activities of daily living. To extend the little finger, open fasciectomy is selected as a general treatment method. However, postoperative complications have been frequently reported. To solve these problems, finger shortening was undertaken. In this study, we treated two cases of Dupuytren’s disease manifesting severe PIP joint flexion contracture of the little finger with finger shortening by proximodistal interphalangeal (PDIP) fusion in which the middle phalanx is resected and the residual distal and proximal phalanges are fused. For flexion contracture of the MP joint, a percutaneous aponeurotomy using an 18G needle was performed to obtain the extended position of the MP joint. Favorable outcomes with high patient satisfaction, including esthetic aspects of retaining the finger with the nail without complication, were achieved. We report this challenging treatment and its discussion.

The Proximal Interphalangeal Joint in Dupuytren’s Disease

1985 ◽  
Vol 10 (3) ◽  
pp. 358-364
Author(s):  
M. A. TONKIN ◽  
F. D. BURKE ◽  
J. P. W. VARIAN
Keyword(s):  
Surgical Approach ◽  
Proximal Phalanx ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Contracture ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Average Percentage ◽  
Percentage Improvement

In one hundred patients with Dupuytren’s disease, one hundred and fifty-four operations were performed. The average pre-operative proximal interphalangeal joint contracture was 42° and the average percentage improvement in proximal interphalangeal joint extension at post­operative review was 41%. Fourteen amputations were performed (9.1%). The primary deformity is caused by disease involvement of the palmar fascial structures. Secondary changes may prevent correction of the deformity despite excision of the contracted fascia. The anatomy of the joint is reviewed together with the primary and secondary mechanisms of joint contracture in Dupuytren's disease. Arthrodesis, osteotomy of the proximal phalanx and joint replacement are considered as alternatives to amputation when a systematic surgical approach fails to correct the flexion contracture.

scholarly journals Dupuytren’s disease digital radius IV right hand and carpal tunnel syndrome on ipsilateral hand

2015 ◽  
Vol 21 (4) ◽  
pp. 178-185 ◽  
Author(s):  
Sebe Ioana Teona ◽  
I. Lascar ◽  
M. Valcu ◽  
B. Caraban ◽  
Colcigeanu Anca
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Healing Process ◽  
Flexion Contracture ◽  
Dupuytren’S Disease ◽  
Motor Deficit ◽  
Dupuytren's Disease ◽  
Right Hand ◽  
Tunnel Syndrome

Abstract Dupuytren’s contracture is a fibroproliferative disease whose etiology and pathophysiology are unclear and controversial. It is a connective tissue disorder, which takes part in the palmar’s fibromatosis category and has common characteristics with the healing process. Dupuytren’s disease is characterized by the flexion contracture of the hand due to palmar and digital aponevrosis. It generally affects the 4th digital radius, followed by the 5th one. Without surgery, it leads to functional impotence of those digital rays and/or hand. It is associated with other diseases and situational conditions like Peyronie’s disease, the Lederhose disease (plantar fibromatosis), Garrod’s digital knuckle-pads, diabetes, epilepsy, alcoholism, micro traumatisms, stenosing tenosynovitis and not the least with carpal tunnel syndrome. The carpal tunnel syndrome is a peripheral neuropathy with the incarceration of the median nerve at the ARC level, expressed clinically by sensory and motor disturbances in the distribution territory of the median nerve, which cause functional limitations of daily activities of the patient. After the failure of the nonsurgical treatment or the appearance of the motor deficit, is established the open or endoscopic surgical treatment with the release of the median nerve. Postoperative recovery in both diseases is crucial to the functionality of the affected upper limb and to the quality of the patient’s life. The patient, a 61 years old man, admitted to the clinic for the functional impotence of the right hand, for the permanent flexion contracture of the metacarpophalangeal joint (MCP) and proximal interphalangeal joint (PIP) of the 4th finger with extension deficit, for the damage of the thumb pulp clamp of the 4th finger, for nocturnal paresthesia of fingers I-III and pain that radiates into the fingertips. After clinical, paraclinical, imagistic and electrical investigations, surgery is practiced partial aponevrectomy, carpal ligament section, external neurolysis of the median nerve, flexor tendon tenolisys. The particularity of this case is the coexistence of two pathologies: Dupuytren’s disease and carpal tunnel syndrome, the decision to solve in the same operator time and the problem of immobilization. Reportation of this case supports previous reports in literature, such as Dupuytren’s disease and carpal tunnel syndrome are observed at the same patient, at the same time or one after another.

scholarly journals Limited progression of subclinical Dupuytren’s disease

2021 ◽  
Vol 103-B (4) ◽  
pp. 704-710
Author(s):  
Bente A. van den Berge ◽  
Paul M. N. Werker ◽  
Dieuwke C. Broekstra
Keyword(s):  
Family History ◽  
Disease Progression ◽  
Positive Family History ◽  
Dupuytren’S Disease ◽  
Disease Stage ◽  
Patient Specific ◽  
Regression Analyses ◽  
Dupuytren's Disease ◽  
History Of ◽  
Multivariable Regression

Aims With novel promising therapies potentially limiting progression of Dupuytren’s disease (DD), better patient stratification is needed. We aimed to quantify DD development and progression after seven years in a population-based cohort, and to identify factors predictive of disease development or progression. Methods All surviving participants from our previous prevalence study were invited to participate in the current prospective cohort study. Participants were examined for presence of DD and Iselin’s classification was applied. They were asked to complete comprehensive questionnaires. Disease progression was defined as advancement to a further Iselin stage or surgery. Potential predictive factors were assessed using multivariable regression analyses. Of 763 participants in our original study, 398 were available for further investigation seven years later. Results We identified 143/398 (35.9%) participants with DD, of whom 56 (39.2%) were newly diagnosed. Overall, 20/93 (21.5%) previously affected participants had disease progression, while 6/93 (6.5%) patients showed disease regression. Disease progression occurred more often in patients who initially had advanced disease. Multivariable regression analyses revealed that both ectopic lesions and a positive family history of DD are independent predictors of disease progression. Previous hand injury predicts development of DD. Conclusion Disease progression occurred in 21.5% of DD patients in our study. The higher the initial disease stage, the greater the proportion of participants who had disease progression at follow-up. Both ectopic lesions and a positive family history of DD predict disease progression. These patient-specific factors may be used to identify patients who might benefit from treatment that prevents progression. Cite this article: Bone Joint J 2021;103-B(4):704–710.

Dupuytren’s Disease Following Acute Injury in Japanese Patients: Dupuytren’s Disease or Not?

2007 ◽  
Vol 32 (5) ◽  
pp. 569-572 ◽  
Author(s):  
Y. ABE ◽  
T. ROKKAKU ◽  
T. EBATA ◽  
S. TOKUNAGA ◽  
T. YAMADA
Keyword(s):  
Diabetes Mellitus ◽  
Elective Surgery ◽  
Middle Finger ◽  
Japanese Patients ◽  
Flexion Contracture ◽  
Dupuytren’S Disease ◽  
Acute Injury ◽  
Separate Entity ◽  
Dupuytren's Disease ◽  
Age And Sex

This paper reports the development of Dupuytren’s disease following acute injury in 16 hands in 14 Japanese patients. The patients included six women and eight men. Five patients developed disease following trauma, one following infection and eight following elective surgery. In the present series, the patient age and sex are irrelevant. The disease was unilateral, confined to a single digital ray, and without ectopic lesions in most cases. Disease presented predominantly in the ring or middle finger rays. There were only three patients who underwent surgery for definite flexion contracture. Diabetes mellitus was the most frequently associated risk factor. Our results suggest that Dupuytren’s disease following acute injury could be considered a separate entity from typical Dupuytren’s disease. At present, we believe that this condition should be considered a subtype of Dupuytren’s disease.

Dupuytren's Disease—Initial Symptoms, Age of Onset and Spontaneous Course

HAND ◽  
1977 ◽  
Vol os-9 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Otto A. Mikkelsen
Keyword(s):  
Stationary Phase ◽  
Age Of Onset ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Bilateral Disease ◽  
Right Hand ◽  
Initial Symptoms ◽  
Spontaneous Course ◽  
The Right

647 men and 254 women with Dupuytren's disease of the hands were questioned about how, where and when the disease had started. Usually the disease started in the right hand, and nodules in the ulnar part of the palm were the first symptom in 90%. In 10% of the cases with bilateral disease, it started simultaneously in both hands. One woman and two men noticed the first symptom before 10 years of age. In about 50% of the men, the disease started between 40–59 years of age (women 40–69 years). In men the contracture increased rather constantly during the first twenty years, followed by a stationary phase from about 20 to thirty-five years of duration, whereafter it definitely decreased. In women the disease increased gradually with the duration of the disease.

Palmar Segmental Aponeurectomy for Dupuytren’s Disease with Metacarpophalangeal flexion Contracture

2001 ◽  
Vol 26 (4) ◽  
pp. 360-361 ◽  
Author(s):  
J. J. CLIBBON ◽  
A. M. LOGAN
Keyword(s):  
Flexion Contracture ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Limited Fasciectomy

Eighty palmar segmental aponeurectomies were performed between 1993 and 1999 for well-localized palmar cords with metacarpophalangeal flexion contracture. A retrospective patient review with a minimum follow-up of 1-year demonstrated a 6% rate of recurrent metacarpophalangeal flexion and two minor complications. Segmental aponeurectomy rather than limited fasciectomy is recommended for this type of disease.

Functional Benefit of Dupuytren’s Surgery

2002 ◽  
Vol 27 (4) ◽  
pp. 378-381 ◽  
Author(s):  
R. SINHA ◽  
T. R. CRESSWELL ◽  
R. MASON ◽  
I. CHAKRABARTI
Keyword(s):  
Hand Function ◽  
Dupuytren’S Disease ◽  
Flexion Deformity ◽  
Dupuytren's Disease ◽  
Functional Benefit ◽  
Operative Result ◽  
The Mean ◽  
Results Of Surgery

The results of surgery for Dupuytren’s disease were prospectively assessed to see if there is a correlation between hand function, the degree of deformity and the post-operative result. A total of 42 patients were followed-up for 6 months. The mean flexion deformity was 81° pre-operatively and 32° post-operatively. The mean Sollerman score improved from 71 (out of 80) pre-operatively to 77 post-operatively. There was a significant correlation between the degree of deformity and the Sollerman score, and also between the improvement in deformity after surgery, and the Sollerman score. We conclude that hand function is worsened by increasing deformity in Dupuytren’s disease and improved by correction of the deformity.

Sign in / Sign up

Export Citation Format

Share Document