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Tiberiu Paul Neagu, Mirela Ţigliş, Andreea Popescu, Valentin Enache, Şerban Arghir Popescu, Ioan Lascăr
Ledderhose disease or plantar fibromatosis is a rare hyperproliferative disorder of the plantar aponeurosis, clinically characterized by nodules situated especially on the medial border of the foot. It is histopathologically associated with Dupuytren's disease. This disease has some risk factors, like old age, alcohol or nicotine abuse, liver dysfunction, trauma or exposure to vibrations and autoimmune disorders, but the exact etiology is still unknown. Even though it is benign, the local manifestations can be aggressive, leading to debilitating deformities and contractures of the toes...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Mary Kate Thayer, Jeremy S Somerson, Jerry I Huang
Background: Collagenase Clostridium histolyticum (CCH) injection has been shown to be a safe and effective treatment option for Dupuytren's contracture. We hypothesize that the gaining popularity of CCH has resulted in a change in treatment patterns among providers, with increased utilization of CCH injections in the management of Dupuytren's contracture from 2012 to 2014. Methods: The Medicare Provider Utilization and Payment Data Public Use Files were used to identify all surgeons who submitted claims for surgical fasciectomy, needle aponeurotomy (NA), and CCH injection...
October 2018: Plastic and Reconstructive Surgery. Global Open
Ruud W Selles, Chao Zhou, Hester J Kan, Robbert M Wouters, Christianne A van Nieuwenhoven, Steven E R Hovius
BACKGROUND: In the Dupuytren Rotterdam randomized controlled trial, percutaneous aponeurotomy with lipofilling (PALF) was as effective as limited fasciectomy in correcting primary Dupuytren's contracture after 1 year. The authors report the 5-year results of this trial, with a special focus on recurrence of contractures. METHODS: The authors invited all patients who had undergone PALF or limited fasciectomy to participate in a posttrial follow-up assessment. Thirty-one PALF patients and 21 limited fasciectomy patients were assessed by an independent examiner for the degree of contracture and whether patients had undergone a secondary procedure...
December 2018: Plastic and Reconstructive Surgery
Benjamin H Miranda, Charlotte Elliott, Christopher C Kearsey, David N Haughton, Mark R Webb, Ian Harvey, Fahmy S Fahmy
BACKGROUND: Numerous Dupuytren's fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren's disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren's disease and unite current limited fasciectomy practice that varies considerably between surgeons. METHODS: We describe the 3DF principles; raising thin skin flaps (addressing dermal involvement), excising diseased palmar fascia with a 3-5 mm clearance margin (treating highly locally recurrent conditions) and excising the vertical septae of Legueu and Juvara (providing deep clearance, hence addressing all potentially involved pathological tissue)...
November 2018: Archives of Plastic Surgery
Grazia Aleppo, Lauren G Kanapka, Nicole C Foster, Mengdi Wu, Mark A Clements, Michael R Rickels, Janet B McGill, Roy W Beck
BACKGROUND: Diabetic cheiroarthropathy is a long-term complication of diabetes that causes significant morbidity and can impair functional abilities. It has not been well studied in individuals with type 1 diabetes (T1D). The T1D Exchange registry provided an opportunity to assess the frequency of cheiroarthropathy and related characteristics. MATERIALS AND METHODS: An internet-based survey was sent to 6,199 registry participants >18 years old, with 1,911 (31%) responding (62% female, 90% non-Hispanic White, mean age 40 yrs, median diabetes duration 20 yrs, mean HbA1c 7...
November 1, 2018: Endocrine Practice
Jesper Nordenskjöld, Stina Brodén, Isam Atroshi
BACKGROUND: The most commonly reported outcome measure in Dupuytren disease is the extension deficit in finger joints. This study aimed to investigate the examiners' influence on the measured difference between active and passive extension deficit. METHODS: A prospective cohort study was conducted on 157 consecutive patients (81% men, mean age 70 years) scheduled for collagenase treatment for Dupuytren disease. Before injection, one of three experienced hand therapists measured active extension deficit (AED) and passive extension deficit (PED) in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the affected fingers using a hand-held metal goniometer...
October 29, 2018: BMC Medical Research Methodology
Ahmad J Abdulsalam, Dia Shehab, Adlia Abd Elhady, Mini Abraham
BACKGROUND: Dupuytren's disease of the hand is characterized by progressive thickening and shortening of palmar fascia resulting in flexion deformities of the digits and hence limitation of hand function. The objective of this study was to evaluate the effectiveness of shock-wave therapy on patients with Dupuytren's disease of the hand. CASE SERIES: A case series study observed a total of four patients with Dupuytren's disease of the hand. All four patients had diabetes...
October 29, 2018: European Journal of Physical and Rehabilitation Medicine
Werner Girsch, Rohit Arora, Eva-Maria Baur, Markus Gabl, Dietmar Hager, Thomas Hintringer, Lars-Peter Kamolz, Rupert Koller, Christian Krasny, Martin Leixnering, Walpurga Lick-Schiffer, Matthias Rab, Ingrid Schlenz, Gottfried Wechselberger, Gerlinde Weigel, Armin Zadra, Robert Zimmermann
Dupuytren's contracture (DC) or Dupuytren's disease (DD) is a progressive fibro-proliferative disease of palmoplantar connective tissue, resulting in characteristic nodal and/or cord formation from collagen disposition. When the disease progresses, the thickening and shortening of the cords eventually leads the affected fingers to being pulled into flexion, which may be associated with marked disability, especially with bilateral disease. DD is relatively common in Europe, with the highest prevalence in Nordic countries...
October 17, 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Antonio Furlan, Roberto Stramare
PURPOSE: To investigate the frequency of thickening of pulleys for flexor tendons in patients with early arthritis in their hands, and to evaluate it as a predictive sign of PsA. METHODS: A prospective observational study involving 228 consecutive patients presenting with recent onset of arthritis in their hands was conducted at rheumatology outpatient clinics in the Veneto region of Italy between October 2014 and September 2017. Diabetic patients were excluded because of the high frequency of trigger finger...
December 2018: Journal of Ultrasound
Mario Fuiano, Massimiliano Mosca, Silvio Caravelli, Simone Massimi, Maria Grazia Benedetti, Francesco Di Caprio, Salvatore Mosca, Stefano Zaffagnini
BACKGROUND: Plantar fibromatosis, or Ledderhose disease, is a benign and hyperproliferative disease of the plantar aponeurosis. There have been described different therapeutic options regarding plantar fibromatosis, both conservative and surgical. The aim of this review is to systematically analyze conservative and operative treatments of plantar fibromatosis described in literature, evaluating which procedure shows the highest success rate and best functional outcome. METHODS: A systematic review of PubMed, Google Scholar and Cochrane reviews computerized database was performed focusing on the different types of treatments for plantar fibromatosis...
June 11, 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Andrew K Sefton, Belinda J Smith, David A Stewart
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...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Takako Kanatani, Issei Nagura, Yoshifumi Harada
We describe our injection method for Collagenase Clostridium Histolyticum using a medical silicone tube after determining the optimal depth by ultrasonography. This procedure adjusts the exposed needle length to the planned injection depth by placing a sterilized silicone tube over the needle. The restricted depth provides not only precise injection into the middle of the cords but also avoids needle tip migration through the cord and into the vital structures, which prevents possible complications. This method is safe and simple...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Daan C J Mohede, Igle Jan de Jong, Ruud A Bank, Mels F van Driel
INTRODUCTION: In Europe and the United States, verteporfin (Visudyne; VP) is registered and used in treating macular degeneration. Research showed that VP decreased expression of fibrotic genes in fibroblasts collected from nodules of patients suffering from Dupuytren's disease, plausibly by de-activating transcription in the Yes Activated Protein (YAP) pathway. AIM: To analyze the effect of VP on myofibroblasts cultured from Peyronie's disease (PD) plaques. METHODS: At surgery for PD we took biopsies from the plaques of 5 patients...
September 28, 2018: Sexual Medicine
B B Burger, M M Veerman, M A Tellier, W K G Leclercq, C M Mouës-Vink, P M N Werker
BACKGROUND: Literature suggests that patient-informing process prior to obtaining surgical informed consent (SIC) does not function well. This study aimed to provide insight into the current practice of SIC in the Netherlands. METHODS: This is a prospective, observational, and multicenter study, conducted in one academic and two non-academic teaching hospitals in the Netherlands. Audio recordings were made during outpatient consultations with patients presenting with Dupuytren Disease...
September 28, 2018: World Journal of Surgery
Franck M Leclère, Sabine Kohl, Cédric Varonier, Frank Unglaub, Esther Vögelin
INTRODUCTION: In Switzerland, collagenase Clostridium histolyticum therapy (CCH) for Dupuytren's disease was introduced in 2011. This study analyzes possible differences between CCH and limited fasciectomy (LF) in terms of range of motion, patient satisfaction and postoperative rehabilitation. MATERIALS AND METHODS: This retrospective study included 52 patients with Dupuytren's disease stage 1-3 according to Tubiana, treated with CCH or LF between January 2012 and December 2013...
November 2018: Archives of Orthopaedic and Trauma Surgery
Nathalia Shchudlo, Tatyana Varsegova, Tatyana Stupina, Tamara Dolganova, Michael Shchudlo, Nathalia Shihaleva, Vadim Kostin
AIM: To investigate the structural and functional characteristics of palmar hypodermal tissue vascularization in Dupuytren's contracture patients of different age groups. METHODS: Eighty-seven Dupuytren's contracture patients underwent partial fasciectomy. Twenty-two of them were less than 55 years old (Y-group, n = 22); the others were 55 and older (O-group, n = 65). In surgically excised representative tissue samples, a histomorphometric analysis of the perforating arteries of the palmar aponeurosis and stereologic analysis of hypodermis vascularity were performed...
September 18, 2018: World Journal of Orthopedics
Rafael Sanjuan-Cerveró, Francisco J Carrera-Hueso, Pedro Vazquez-Ferreiro
BACKGROUND: Collagenase clostridium histolyticum is now recognized as a viable treatment for Dupuytren disease. The high rate of adverse effects reported in patients continues to spark debate and raise questions about the true frequency of effects and their associated mechanisms of action. HYPOTHESIS: To investigate whether outcomes of CCH treatment are related to the number of adverse effects experienced. To evaluate short-term clinical outcomes in a series of patients...
October 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Thibault Gerosa, Jérôme Pierrart, Julien Serane-Fresnel, Lior Amsallem, Emmanuel H Masmejean
PURPOSE: Dupuytren's disease is a common and disabling condition. Its pathophysiology is not well understood. Some patients complain of postoperative loss of fingertip sensitivity that could be due either to the surgery or to the disease itself. Our hypothesis is that distal sensory disorders are a component of Dupuytren's disease. METHODS: We performed a prospective, single-center study to compare two populations: controls and patients with Dupuytren's disease...
October 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Serafin García-Mata, Julio Duart-Clemente
We report the case of a 13-year-old girl who presented with a fibrous nodular lesion on the palm of her hand. After ultrasonographic examination, surgical resection of the skin (dermofasciectomy) was performed, and a nodular phase mass was recovered, characterized as fusocellular fibroblast proliferation in a dense collagenous stroma with a cell population consisting of parallel fascicles of densely packed fusiform cells of a fibroblast strain. No signs of encapsulation or malignant changes were observed, all of which was consistent with Dupuytren's disease...
September 13, 2018: Journal of Pediatric Orthopedics. Part B
Claudia Sicher, Rico Rutkowski, Stine Lutze, Sebastian von Podewils, Thomas Wild, Markus Kretching, Georg Daeschlein
There is a lack of imaging tools for the evaluation of spatial alterations in microcirculation including blood oxygen saturation and hemoglobin distribution but recent innovative developments in hyperspectral technology may offer a solution. We examined different hemodynamic disorders in patients suffering from scleroderma, Dupuytren surgery, chronic foot ulcera and skin infections. Superficial and deeper blood oxygen saturation, hemoglobin distribution and water content were determined using hyperspectral imaging (HSI)...
October 25, 2018: Biomedizinische Technik. Biomedical Engineering
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