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Ilse Degreef
Dupuytren disease is highly prevalent and the finger contractures can be very extensile, compromising the patients' hand function. To restore full function, contractures have been addressed by cutting the causative strands for nearly 200 years, ever since Baron Guillaume Dupuytren demonstrated his technique at the beginning of the nineteenth century. Surgery can be minimal (fasciotomy) or quite invasive (fasciectomy and even skin replacement). However, in the last decade translational research has introduced the non-surgical technique of enzymatic fasciotomy with collagenase injections...
June 2016: Rheumatol Ther
Clara Ferreira, Daniel Johnson, Karl Rasmussen, Clinton Leinweber, Salahuddin Ahmad, Jae Won Jung
PURPOSE: To develop a novel conformal superficial brachytherapy (CSBT) device as a treatment option for the patient-specific radiation therapy of conditions including superficial lesions, postsurgical positive margins, Dupuytren's contractures, keloid scars, and complex anatomic sites (eyelids, nose, ears, etc.). METHODS AND MATERIALS: A preliminary CSBT device prototype was designed, built, and tested using readily available radioactive seeds. Iodine-125 ((125)I) seeds were independently guided to the treatment surface to conform to the target...
October 3, 2016: Brachytherapy
F Verstreken, I Degreef, A Decramer, K Libberecht, W Vanhove, A Datco, J Vanhaecke, D Clermont, J Duerinckx
Dupuytren's disease is a connective tissue disorder leading to contractures. It can be treated surgically or through injections of collagenase Clostridium histolyticum (CCH). Patients with Dupuytren's contracture (> 20°) and a palpable cord were included in this observational study, aiming to characterise the Belgian patient population and to assess the effectiveness and safety of CCH. Overall, 108 patients (114 joints) received at least one injection of CCH, and 104 patients completed the study. The percentages of joints achieving a degree of contracture of 5° or less, or a relative contracture reduction of at least 50% after the extension procedure were 64...
August 2016: Acta Orthopaedica Belgica
Dieuwke C Broekstra, Edwin R van den Heuvel, Rosanne Lanting, Tom Harder, Inge Smits, Paul M N Werker
BACKGROUND/AIM: Dupuytren disease is a fibroproliferative hand condition. The role of exposure to vibration as a risk factor has been studied with contradictory results. Since field hockey is expected to be a strong source of hand-arm vibration, we hypothesised that long-term exposure to field hockey is associated with Dupuytren disease. METHODS: In this cross-sectional cohort study, the hands of 169 male field hockey players (IQR: 65-71 years) and 156 male controls (IQR: 59-71 years) were examined for signs of Dupuytren disease...
September 22, 2016: British Journal of Sports Medicine
R Sanjuan-Cervero, J E Poquet-Jornet, F J Carrera-Hueso
OBJECTIVE: Secondary effects and drug reactions relative to collagenase Clostridium histolyticum treatment for Dupuytren's contracture are frequent. In only a few cases these secondary effects are considered serious. The mechanism that produces these effects of production is not well understood. CLINICAL REPORT: We present the case report of a woman with fifth finger interphalangeal joint treatment with generalized skin rash as a complication of collagenase Clostridium histolyticum treatment...
September 2016: European Review for Medical and Pharmacological Sciences
S Karkampouna, M Kreulen, M C Obdeijn, P Kloen, A L Dorjée, F Rivellese, A Chojnowski, I Clark, Marianna Kruithof-de Julio
Dupuytren's disease is a connective tissue disorder of the hand causing excessive palmar fascial fibrosis with associated finger contracture and disability. The aetiology of the disease is heterogeneous, with both genetic and environmental components. The connective tissue is abnormally infiltrated by myofibroblasts that deposit collagen and other extracellular matrix proteins. We describe the clinical profile of Dupuytren's disease along with current therapeutic schemes. Recent findings on molecular and cellular parameters that are dysregulated in Dupuytren's disease, which may contribute to the onset of the disease, and the role of resident inflammation promoting fibrosis, are highlighted...
2016: Current Molecular Biology Reports
N Nand, S Dsouza, N Batra, V Chauhan, M Yadav
No abstract text is available yet for this article.
October 2015: Journal of the Association of Physicians of India
A H Wormdal, S H Tallaksen, Ø Hagen, O E Foss, V Finsen
: The Quick disabilities of the arm, shoulder and hand (QuickDASH) patient-reported outcome measure is frequently used to assess disabilities and symptoms of the upper extremity. This study compares real preoperative QuickDASH scores and remembered preoperative QuickDASH scores. Remembered preoperative QuickDASH scores were obtained 45 months (39-67) after surgery. Patient material consisted of 160 patients operated for Dupuytren's contracture, carpal tunnel syndrome, thumb basal joint arthrosis, and shoulder pain...
September 5, 2016: Journal of Hand Surgery, European Volume
Chao Zhou, Steven E R Hovius, Harm P Slijper, Michiel J Zuidam, Xander Smit, Reinier Feitz, Ruud W Selles
BACKGROUND: This study examined patient satisfaction with hand function after fasciectomy for Dupuytren's contracture and determined which preoperative patient- and disease-specific factors predicted this satisfaction. METHODS: Demographics and disease-specific factors were assessed from a prospective cohort of 194 patients who completed the Michigan Hand Outcomes Questionnaire preoperatively and underwent limited fasciectomy between 2011 and 2014 at six hand surgery practice sites...
September 2016: Plastic and Reconstructive Surgery
M Neuwirth, A Binter, W Pipam, M Rab
INTRODUCTION: Since Dupuytren's contracture is a common disorder, the costs for its surgical treatment impose a considerable burden on the healthcare system. For the first time in the German-speaking area, this study aimed to provide a comparative cost-effectiveness analysis for partial fasciectomy vs. treatment with Clostridium histolyticum collagenase (CCH). METHODS: A retrospective monocentric study of the period from 2012 to 2014 comprised 40 patients with previously untreated Dupuytren's contracture of one finger...
August 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
John Z Zhao, Scott Hadley, Emerson Floyd, Brandon E Earp, Philip E Blazar
PURPOSE: The U.S. Food and Drug Administration approved the use of collagenase Clostridium histolyticum (CCH) in the United States in February 2010. This study addresses the impact of that approval on the number of Dupuytren contracture (DC) encounters and treatment patterns in the United States. METHODS: Using the Intercontinental Marketing Services Health Office-Based Medical Claims database, we identified the monthly number of DC encounters and DC procedures between January 2007 and December 2013...
October 2016: Journal of Hand Surgery
Catherine Ball, David Izadi, Liaquat Suleman Verjee, James Chan, Jagdeep Nanchahal
BACKGROUND: Dupuytren's disease is a common fibrotic disorder of the palm characterized by the development of progressive flexion deformities in the digits, leading to significant functional impairment. Surgical excision remains the most common treatment. However, this is only indicated in patients with established contractures rather than those with early disease. Early disease is generally characterized by the presence of palmar nodules with limited or no contracture of the fingers...
2016: BMC Musculoskeletal Disorders
A A Gusarov, V A Fetisov, Yu O Kucheryavets
This article reports the results of the commission forensic medical expertise undertaken to evaluate the possibility of severe injury to the ankle joint resulting from the road traffic accident as exemplified by the collision of a VAS 21043 car moving backward with a pedestrian. It was shown that the injury to the victim's right lower leg included the tear of the right crural deltoid ligament, the open communicated fracture of the lower third of fibular diaphysis with the displacement of the distal fragment, the lacerated wound in the lower third of the right leg, the rupture of distal tibiofibular synedesmosis, the closed communicated fracture of the posterior edge of the tibia without displacement, and outward subluxation of the right foot...
July 2016: Sudebno-meditsinskaia Ekspertiza
Wen-Hsuan Hou, Chung-Yi Li, Lu-Hsuan Chen, Liang-Yi Wang, Ken N Kuo, Hsiu-Nien Shen, Ming-Fong Chang
BACKGROUND: Population-based data for diabetic hand syndrome (DHS) are limited. The aim of the present epidemiological study was to estimate the overall and cause-specific prevalence and rate ratio (RR) of DHS in patients with diabetes. METHODS: The present study was a cross-sectional study based on a random sample of 57 093 diabetics and matched controls, both identified from Taiwan National Health Insurance claims in 2010. The DHS analyzed in the present study included carpal tunnel syndrome (CTS), stenosing flexor tenosynovitis (SFT), limited joint mobility (LJM), and Dupuytren's disease (DD)...
August 3, 2016: Journal of Diabetes
J N Rodrigues, W Zhang, B E Scammell, I Chakrabarti, P G Russell, S Fullilove, D Davidson, T R C Davis
: Variables associated with recurrent Dupuytren's disease, or a 'diathesis', have been investigated, but those associated with functional outcome and complications are less well studied. Outcomes 1 or 5 years after an aponeurotomy, fasciectomy or dermofasciectomy were assessed by patient interview and examination at five UK centres. A total of 432 procedures were studied. The reoperation rate did not differ at 1 year (p = 0.396, Chi-square test with Monte Carlo simulation), but was higher after aponeurotomy in the 5-year group (30%, versus 6% after fasciectomy and 0% after dermofasciectomy, p = 0...
July 29, 2016: Journal of Hand Surgery, European Volume
Joakim Strömberg, Allan Ibsen-Sörensen, Jan Fridén
PURPOSE: This study compared the efficacy of collagenase treatment and needle fasciotomy for contracture of the metacarpophalangeal (MCP) joint in Dupuytren disease. METHODS: This is a prospective, single-blinded, randomized study with follow-up 1 week and 1 year after treatment. One hundred and forty patients with an MCP contracture of 20° or more in a single finger were enrolled, of whom 69 patients were randomized to collagenase treatment and 71 patients to needle fasciotomy...
September 2016: Journal of Hand Surgery
Martina Wehrli, Stefanie Hensler, Stephan Schindele, Daniel B Herren, Miriam Marks
PURPOSE: The brief Michigan Hand Outcomes Questionnaire (briefMHQ) was developed as a shorter version of the Michigan Hand Outcomes Questionnaire (MHQ), but its measurement properties have not been investigated in patients with Dupuytren contracture. The objective of the study was to investigate the reliability, validity, responsiveness, and interpretability of the briefMHQ. METHODS: Fifty-seven patients diagnosed with Dupuytren contracture completed the briefMHQ as well as the full-length MHQ and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at baseline...
September 2016: Journal of Hand Surgery
Kerstin Becker, Sabine Siegert, Mohammad Reza Toliat, Juanjiangmeng Du, Ramona Casper, Guido H Dolmans, Paul M Werker, Sigrid Tinschert, Andre Franke, Christian Gieger, Konstantin Strauch, Michael Nothnagel, Peter Nürnberg, Hans Christian Hennies
Dupuytren´s disease, a fibromatosis of the connective tissue in the palm, is a common complex disease with a strong genetic component. Up to date nine genetic loci have been found to be associated with the disease. Six of these loci contain genes that code for Wnt signalling proteins. In spite of this striking first insight into the genetic factors in Dupuytren´s disease, much of the inherited risk in Dupuytren´s disease still needs to be discovered. The already identified loci jointly explain ~1% of the heritability in this disease...
2016: PloS One
Adalsteinn Odinsson, Lars Erik Brenne, Tone Bøyesen Lurie, Vilhjalmur Finsen
BACKGROUND: Our main goal was to see if treatment with collagenase injection is safe and effective and to assess patient satisfaction with this new treatment. METHODS: We prospectively followed 77 consecutive patients, treated for contracture in 91 fingers and 142 joints that received total of 109 collagenase injections. The patients were reviewed on the first and second day and at 4 and 12 months. A contracture reduced to five degrees or less at 12 months after the last injection, was considered to be a successful outcome...
June 2016: J Hand Surg Asian Pac Vol
Franco Bassetto, Nicola Maschio, Giovanni Abatangelo, Barbara Zavan, Carlotta Scarpa, Vincenzo Vindigni
Purpose The purpose of this study is to examine the activity of collagenase from cultures of Vibrio alginolyticus as in vitro as in biological samples and to evaluate clinical perspectives of this product about the treatment of fibroproliferative diseases like Dupuytren's contracture. Methods The experimental part of the study has been divided in 2 stages. In the first stage, the collagenase has been produced in laboratory, assessing its purity, verifying the in vitro degradation of collagen by the enzyme and measuring the size of the fragments; in the second part, an experimental injection into samples of fibrous cord typical of Dupuytren's disease has been performed in vitro...
July 22, 2016: Surgical Innovation
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