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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...
October 15, 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...
September 26, 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
Jan Kriz, Heinrich M Seegenschmiedt, Amelie Bartels, Oliver Micke, Ralph Muecke, Ulrich Schaefer, Uwe Haverkamp, Hans T Eich
Purpose: Radiation therapy (RT) is a common treatment for benign diseases in Germany. Because the treatment concepts are inconsistent, we conducted this pattern-of-care study on behalf of the German Cooperative Group on Benign Diseases to evaluate treatment standards in Germany. Methods and materials: Questionnaires were mailed to all radiation therapy facilities in Germany. We assessed the treatment equipment, annual number of patients, treatment indications, and, in particular, treatment strategies in patients with benign diseases in 2014...
July 2018: Advances in Radiation Oncology
Rinze L Zwanenburg, Duncan A McGrouther, Paul M N Werker
PURPOSE: Grayson ligament has been described as a common pathway for digital contracture in Dupuytren disease. Its anatomical descriptions in the literature are, however, inconsistent. METHODS: We have performed a microsurgical dissection study in 20 fresh-frozen and thawed digits to revisit the anatomy of Grayson ligaments. We also performed dissections in Thiel-preserved hands to be able to study the changes in tension of the ligaments during flexion and extension of the finger...
August 28, 2018: Journal of Hand Surgery
Virginie Tourreil, Guillaume Giran, Nadia Benmoussa, Giovanna Paternoster, Patrick Conan, Philippe Charlier, Roman Hossein Khonsari
The Musée Dupuytren was a Parisian pathology museum established in 1835. This museum hosted 3 skulls with severe craniofacial lesions initially tagged as aggressive forms of tinea capitis. The aim of this study was to investigate these specimens and discuss the initial diagnosis. Historical investigations were conducted based on the biographic data from the tags of the 3 skulls and entries on the catalog of the museum. Age was determined using dentition and the patency of cranial base synchondroses. The computed tomography scans were performed using standard medical devices...
October 2018: Journal of Craniofacial Surgery
E Soreide, M H Murad, J M Denbeigh, E A Lewallen, A Dudakovic, L Nordsletten, A J van Wijnen, S Kakar
Aims: Dupuytren's contracture is a benign, myoproliferative condition affecting the palmar fascia that results in progressive contractures of the fingers. Despite increased knowledge of the cellular and connective tissue changes involved, neither a cure nor an optimum form of treatment exists. The aim of this systematic review was to summarize the best available evidence on the management of this condition. Materials and Methods: A comprehensive database search for randomized controlled trials (RCTs) was performed until August 2017...
September 2018: Bone & Joint Journal
Juan Rodolfo Mella, Lifei Guo, Virginia Hung
Dupuytren's contracture, a benign condition characterized by fibrosis of the palmar and digital fascia, may be a debilitating condition that limits daily function. Several techniques exist for managing symptomatic contractures of the hand related to Dupuytren's. These techniques include the more invasive open fasciotomy or fasciectomy. More recently, less invasive techniques including administration of collagenase Clostridium histolyticum (CCH) or percutaneous needle aponeurotomy (PNA) have become part of the treatment armamentarium...
August 29, 2018: Annals of Plastic Surgery
Joseph P Corkum, Joshua A Gillis, David T Tang
Purpose: Surgeons and resident physicians in a clinic setting often visually estimate Dupuytren flexion contractures of the hand to follow disease progression and decide on management. No previous study has compared visual estimates with a standardized instrument to ensure measurement reliability. Methods: Consecutive patients consulted for Dupuytren flexion contractures of the hand had individual joint contractures estimated in degrees (°) by both a resident physician and staff surgeon...
August 2018: Plastic Surgery
Timothy T Fei, Evan Chernoff, Nathan A Monacco, David E Komatsu, Samantha Muhlrad, Steven P Sampson, Lawrence C Hurst, Alexander B Dagum
PURPOSE: To explore the efficacy of injectable collagenase Clostridium histolyticum (CCH) in distal interphalangeal (DIP) joint contractures in Dupuytren disease. METHODS: A retrospective review was conducted for patients with DIP joint contractures treated with CCH. Baseline contracture and posttreatment residual contracture were recorded. The primary end point was achievement of 0° to 5° of residual contracture 30 days postmanipulation. Recurrence and adverse events are also reported...
August 23, 2018: Journal of Hand Surgery
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