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.

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

Cost Comparison of Collagenase Clostridium Histolyticum and Fasciectomy for Treatment of Dupuytren’s Contracture in the Australian Health System

2018 ◽  
Vol 23 (03) ◽  
pp. 336-341 ◽  
Author(s):  
Andrew K. Sefton ◽  
Belinda J. Smith ◽  
David A. Stewart
Keyword(s):  
Treatment Options ◽  
Cost Comparison ◽  
Dupuytren’S Disease ◽  
Dupuytren’S Contracture ◽  
Collagenase Clostridium Histolyticum ◽  
Health Care Environment ◽  
Dupuytren's Disease ◽  
Australian Health ◽  
Dupuytren's Contracture ◽  
Clostridium Histolyticum

Background: Dupuytren’s disease results in contracted cords in the hand that lead to deformity and disability. Current treatment options include fasciectomy and an injectable, collagenase clostridium histolyticum. No cost comparison studies have been published within the Australian health care environment. Methods: A retrospective review of all patients treated for Dupuytren’s disease in a major teaching hospital was undertaken to compare the costs of treatment by fasciectomy or collagenase injection. Results: Eighteen patients underwent fasciectomy and 21 collagenase clostridium histolyticum injections were performed during the study period and were eligible for inclusion under the review criteria. Of the 39 patients, 36 were male and 3 were female with an average age 66.4 years (50–85). Twenty-five digits were treated by fasciectomy in 18 patients, and 23 digits were treated by collagenase in 21 patients. The fasciectomy group attended an average 9.2 visits (5–22), incurring an average costing of US$5738.12 per patient ($3181.18–$9618.10). The collagenase group attended an average 3.8 visits (3–8), incurring an average costing of US$2076.83 per patient ($1842.24–$3929.57). Conclusions: Collagenase treatment of Dupuytren’s contracture represents a significant reduction in cost relative to fasciectomy, with 64% savings, length of follow up and number of visits. This is a similar finding to studies in other countries.

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

scholarly journals Dupuytren’s disease: where do we stand?

2019 ◽  
Vol 4 (2) ◽  
pp. 63-69 ◽  
Author(s):  
Rita Grazina ◽  
Sérgio Teixeira ◽  
Renato Ramos ◽  
Henrique Sousa ◽  
Andreia Ferreira ◽  
...  
Keyword(s):  
Alcohol Intake ◽  
State Of The Art ◽  
Treatment Options ◽  
Daily Activities ◽  
Dupuytren’S Disease ◽  
High Morbidity ◽  
Disease Treatment ◽  
Dupuytren's Disease ◽  
Current State ◽  
The World

Dupuytren’s disease is a fibroproliferative disease that involves collagen deposition, leading to hand contractures that ultimately affect hand mobility and grip strength. It is a benign disorder but can cause high morbidity by limiting daily activities. Many factors have been proposed for its aetiology: namely genetics, smoking, alcohol intake and diabetes. However, there is still controversy as to the main aetiological cause of the disease. Treatment is not yet uniform around the world and still varies with the surgeon’s experience and preference. In this review, the authors review the pathogenesis and treatment options for Dupuytren’s disease in an attempt to summarize the current state of the art. Cite this article: EFORT Open Rev 2019;4:63-69. DOI: 10.1302/2058-5241.4.180021.

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