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Ryosuke Kakinoki, Kazuhiro Ohtani, Kazuhiko Hashimoto, Hiroki Tanaka, Ryosuke Ikeguchi, Souichi Ohta, Masao Akagi
Dupuytren's pathologic tissue usually involves the palmar skin and rarely infiltrates into the dorsal skin. In this study, we hypothesized that transplantation of a vascularized cutaneous flap harvested from the dorsum of the hand to the palmar skin, under which the pathologic cord existed might be useful for blocking reformation of the pathologic cords and for decreasing the recurrence rate. After removal of the pathologic tissue under the palmar skin, we harvested 2 types of skin islands nourished by the dorsal digital arterial network including the dorsal perforating arteries arising from the palmar digital arteries...
August 4, 2018: Techniques in Hand & Upper Extremity Surgery
S Roulet, G Bacle, J Guéry, B Charruau, E Marteau, J Laulan
The goal of this study was to assess the recurrence of Dupuytren's disease and the stability of the functional result after fasciectomy combined with the McCash open-palm technique. From 1989 to 1999, 56 consecutive patients were surgically treated for Dupuytren's disease. In 2003, 40 of these operated patients were reviewed by an independent evaluator; 12 patients were Tubiana stage 1, 16 stage 2, 9 stage 3 and 3 stage 4. Twenty-one of them were reviewed again in 2016 by a second evaluator who was unaware of the clinical results in 2003...
August 2, 2018: Hand Surgery and Rehabilitation
Jens C Werlinrud, Karina L Hansen, Søren Larsen, Jens Lauritsen
This study assesses the joint-specific sustained effect of collagenase clostridium histolyticum treatment of Dupuytren disease over a 5-year follow-up period. The study includes 107 consecutive treatments in patients with extension deficits greater than 20° affecting the metacarpophalangeal or proximal interphalangeal joints. Success was defined as no follow-up treatment due to relapse or maintained extension deficit less than 20°. The 5-year estimate of no follow-up treatment was 79% (95% CI: 64-88) for metacarpophalangeal and 49% (95% CI: 26-69) for proximal interphalangeal joints, which was a significant difference (log-rank test, p = 0...
August 2, 2018: Journal of Hand Surgery, European Volume
Jong Hun Baek, Duke Whan Chung, Jae Hoon Lee
PURPOSE: This study aimed to investigate the incidence and prognostic factors for prolonged postoperative symptoms after open A1 pulley release in patients with trigger finger, despite absence of any complications. METHODS: We reviewed 109 patients (78 single-finger involvement, 31 multiple-finger involvement) who underwent open A1 pulley release for trigger finger from 2010 to 2016, with 8 weeks or longer postsurgical follow-up and without postoperative complications...
July 25, 2018: Journal of Hand Surgery
Wolfgang Paul Lenze, Jörg Pattke
No abstract text is available yet for this article.
June 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Bert Reichert, Magnus Baringer
AIM: This study was performed to determine whether between 2015 and 2017 there has been a change in the preferred method of treatment of Dupuytren disease by German hand surgeons, especially with respect to percutaneous needle fasciotomy. METHOD: In 2015 and 2017, 530 members of the German Society for Surgery of the Hand were invited to take part in an online survey, asking for their preferred treatment for Dupuytren disease, including decision criteria and in relation to Tubiana stages...
June 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Logan Carr, Brett Michelotti, Morgan Brgoch, Randy Hauck, John Ingraham
BACKGROUND: Indication for intervention in Dupuytren disease is influenced by many factors, including location and extent of disease, surgeon preference, and comfort level with different treatment techniques. The aim of this study was to determine current Dupuytren disease management trends. METHODS: A questionnaire was sent through the American Society for Surgery of the Hand to all members. In addition to demographic data, questions focused on indications for different procedural interventions based on location of disease, age, and activity level of the patient...
July 25, 2018: Hand: Official Journal of the American Association for Hand Surgery
Gary M Pess, Maj Sundbom, Koo Wilson, Daniel Lindqvist, Lars B Dahlin
This post hoc analysis from a multicenter study (NCT01674634) was designed to evaluate the efficacy of collagenase Clostridium histolyticum (CCH) treatment in patients with different stages of Dupuytren contracture. Previously untreated patients who received two concurrent injections of CCH in two affected joints in the same finger were assessed by disease severity (Tubiana stage). The mean (SD) improvement in total fixed flexion contraction (FFC) 31 days post-CCH treatment in 181 patients was: 71.1 (36.5)% for Tubiana I, 77...
July 24, 2018: Journal of Plastic Surgery and Hand Surgery
Latha Satish
No abstract text is available yet for this article.
July 18, 2018: EBioMedicine
Gregory Morris, Jon A Jacobson, Monica Kalume Brigido, Kara Gaetke-Udager, Corrie M Yablon, Qian Dong
OBJECTIVES: To retrospectively characterize the ultrasound appearance of palmar fibromatosis in patients with a surgical or clinical diagnosis of palmar fibromatosis. METHODS: A search of ultrasound reports from 2005 to 2015 and a subsequent search of medical records were performed to identify patients with a surgical or clinical diagnosis of palmar fibromatosis. The ultrasound images were retrospectively reviewed to record the lesion location, size, echogenicity, compressibility, hyperemia, and calcification...
July 19, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Sigrun Hillesund, Ida Fromreide, Olav A Foss, Vilhjalmur Finsen
It would be useful if it were possible for the patients to recreate their pre-operative QuickDASH scores in audits where this score had not been recorded before surgery. We assessed the accuracy of remembered pre-operative QuickDASH scores among 229 consecutive patients and the value of a previously developed algorithm for correcting these scores. Real pre-operative scores and remembered pre-operative scores were compared after a mean of 21 months. Furthermore, the scores of a subgroup of 79 patients with carpal tunnel syndrome, subacromial impingement, thumb basal joint arthrosis or Dupuytren's contracture were corrected using an algorithm...
July 17, 2018: Journal of Plastic Surgery and Hand Surgery
Steven C Haase, Kevin C Chung
No abstract text is available yet for this article.
August 2018: Hand Clinics
Steven C Haase, Kevin C Chung
As minimally invasive options for treatment of Dupuytren contractures become increasingly widespread, it is important that the evidence is carefully evaluated and patients are informed of the risks and benefits of the options available. The authors advocate a shared decision-making process, using evidence-based medicine, to guide patients in their treatment choices. In this article, the authors present their thoughtful approach to selecting the appropriate Dupuytren treatment of patients, along with detailed, practical technical tips to avoid complications during the execution of these interventions; both collagenase injection and limited fasciectomy techniques are described in detail...
August 2018: Hand Clinics
Steven E R Hovius, Chao Zhou
A comparison is provided between minimally invasive techniques and limited fasciectomy (LF) in the treatment of Dupuytren disease. A technique called percutaneous needle aponeurotomy and lipofilling is described. In a randomized controlled trial, there is no significant difference between this technique and LF after 1 year in contracture correction and recurrent contractures. At 5 years postoperative, however, there is a significant change in recurrence rates in favor of LF. Patients with moderate diathesis should choose between minimally invasive technique with early recurrence, fast recovery, and few complications versus late recurrence, slower recovery, and more complications, as observed with LF or dermofasciectomy...
August 2018: Hand Clinics
Frederick Thomas D Kaplan, Nicholas E Crosby
Treatment of recurrent Dupuytren disease is challenging. Multiple options exist, each having relative benefits and weaknesses. Choice for optimal treatment is made on a case-by-case basis, with shared decision making with the patient. Percutaneous and enzymatic techniques are best reserved for patients with well-defined recurrent disease and offer the benefit of quicker recovery with minimal or no scarring. Surgical treatments have higher risks of neurovascular injury and scarring, but lower recurrence rates...
August 2018: Hand Clinics
Christina Turesson
The role of hand therapy in the treatment of Dupuytren disease varies depending on the patient and the procedure. There is limited evidence for hand therapy as a preventive treatment of Dupuytren disease. Before corrective treatment, the hand therapist can contribute with assessments to promote evaluation of outcome. After corrective treatment, hand therapy is tailored to each patient's needs and consists of orthoses, exercise, edema control, and pain or scar management. Orthoses are usually part of the hand therapy protocol after corrective procedures despite lack of strong supporting evidence and should be provided based on individual patient needs...
August 2018: Hand Clinics
Kyle R Eberlin, Chaitanya S Mudgal
Dupuytren contracture is a progressive disease involving collagen within the palmar fascia. When the contracture progresses to meet specific parameters, intervention is considered and includes collagenase injection, percutaneous or open fasciotomy, or palmar fasciectomy. Complications after treatment include contracture recurrence, digital nerve injury or postoperative neurapraxia, flexor tendon injury/rupture, delayed wound healing or skin necrosis, dysvascular digit/arterial injury, hematoma, and infection...
August 2018: Hand Clinics
Paul Binhammer
Despite more than a hundred years of publications on Dupuytren disease, there has been a lack of consensus on definitions and outcomes until recently. Staging and classifications systems have an important historical context; however, more recently, outcomes rely on patient-reported outcomes, angular correction, and definitions of recurrence. This article reviews commonly used assessments, classifications, and staging systems for Dupuytren disease.
August 2018: Hand Clinics
Paul M N Werker, Ilse Degreef
Clinicians struggle with limited efficacy and durability of standard treatments when treating patients with Dupuytren disease diathesis. Alternative treatments such as low-dose radiation therapy in early phase of disease, supplemental pharmacotherapy with anti-inflammatory and/or anti-mitotic drugs, as well as other pharmacologic targets, and more aggressive surgery such as dermofasciectomy all have been reported with variable success or with serious side effects that hamper their standard use. This article gives an overview of the available literature...
August 2018: Hand Clinics
Joseph J Dias, Sheweidin Aziz
This article discusses limited fasciectomy for Dupuytren contracture, reviews the literature to list common complications, addresses the observations that need to be made after surgery, and systematically reviews the literature for 2 clinical questions: (1) regarding leaving wounds open and (2) the use of postoperative splintage.
August 2018: Hand Clinics
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