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https://www.readbyqxmd.com/read/28635316/complications-following-collagenase-treatment-for-dupuytren-contracture
#1
Jennifer Wozniczka, Clifford Canepa, Adam Mirarchi, Joel S Solomon
BACKGROUND: Collagenase Clostridium histolyticum (CCH) injection and manipulation is a relatively new method for treating Dupuytren contracture that is growing in popularity. Although side effects such as swelling and ecchymosis are common, they are typically mild and self-limited. Major complications are rare but have included flexor tendon rupture and complex regional pain syndrome. METHODS: This study describes a case report of 2 patients seen at our institution...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28604542/outcome-of-dupuytren-contractures-after-collagenase-clostridium-histolyticum-injection-a-single-institution-experience
#2
Yin Kan Hwee, Daniel Park, Marisa Vinas, Christopher Litts, David Friedman
BACKGROUND: Collagenase clostridium histolyticum (CCH) injection is an alternative to surgery for patients with Dupuytren disease (DD) of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. The success of surgical and nonsurgical treatment modalities for DD is reported to vary widely between 25% and 80% (J Bone Joint Surg Am. 1985;67:1439-1443; Plast Reconstr Surg. 2007;120:44e-54e; J Bone Joint Surg Am. 2007;89:189-198; J Hand Surg Am. 2011:36:936-942; J Hand Surg Am...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28587568/ultrasonographic-examination-of-the-ruptured-cord-after-collagenase-treatment-or-needle-fasciotomy-for-dupuytren-s-contracture
#3
J Strömberg, P Vanek, J Fridén, Y Aurell
Local treatment of Dupuytren's contracture, either by collagenase or needle fasciotomy, allows disruption of the pathological cord during forced extension. The purpose of this study was to investigate the cord before and after both treatments by ultrasound. A total of 39 patients with a minimum of 20° contracture in the metacarpophalangeal joint were included and randomized to treatment with either collagenase (20 patients) or needle fasciotomy (19 patients). The distance between the distal and the proximal parts of the ruptured cord was measured by ultrasound and the difference in passive joint movement before and after treatment was measured with a goniomenter...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28538569/early-postoperative-results-of-percutaneous-needle-fasciotomy-in-451-patients-with-dupuytren-disease
#4
Sanne Molenkamp, Tanneke A M Schouten, Dieuwke C Broekstra, Paul M N Werker, J Daniel Moolenburgh
BACKGROUND: Percutaneous needle fasciotomy is a minimally invasive treatment modality for Dupuytren disease. In this study, the authors analyzed the efficacy and complication rate of percutaneous needle fasciotomy using a statistical method that takes the multilevel structure of data, regarding multiple measurements from the same patient, into account. METHODS: The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy were analyzed retrospectively...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28507849/difference-in-success-treating-proximal-interphalangeal-and-metacarpophalangeal-joints-with-collagenase-results-of-208-treatments
#5
Karina Liv Hansen, Jens Christian Werlinrud, Søren Larsen, Tune Ipsen, Jens Lauritsen
BACKGROUND: Dupuytren disease (DD) is a fibroproliferative disorder of the palmar fasciae causing extension deficit and impaired hand function. Treatment with injection of collagenase clostridium histolyticum (CCH) is a nonsurgical treatment method. The aim of this study was to evaluate the difference in efficiency and recurrence at 12-month follow-up when treating metacarpophalangeal (MP) and proximal interphalangeal (PIP) joints with CCH. None of the patients had received previous treatments of their condition...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28505213/dupuytren-s-disease-how-to-recognize-its-early-signs
#6
Thomas Auld, Joanne R Werntz
Palmar skin dimpling and nodule or cord formation signal advancing disease. Treatments vary in effectiveness--in part, depending on condition severity.
March 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28505187/recurrence-of-dupuytren-s-contracture-a-consensus-based-definition
#7
Hester J Kan, Frank W Verrijp, Steven E R Hovius, Christianne A van Nieuwenhoven, Ruud W Selles
PURPOSE: One of the major determinants of Dupyutren disease (DD) treatment efficacy is recurrence of the contracture. Unfortunately, lack of agreement in the literature on what constitutes recurrence makes it nearly impossible to compare the multiple treatments alternatives available today. The aim of this study is to bring an unbiased pool of experts to agree upon what would be considered a recurrence of DD after treatment; and from that consensus establish a much-needed definition for DD recurrence...
2017: PloS One
https://www.readbyqxmd.com/read/28490266/radiotherapy-in-dupuytren-s-disease-a-systematic-review-of-the-evidence
#8
M Kadhum, E Smock, A Khan, A Fleming
Radiotherapy has been advocated as an alternative treatment in early Dupuytren's disease. We have systematically reviewed the evidence on the use of radiotherapy in Dupuytren's disease. Only six articles met a minimum set standard, five of which were retrospective cohort studies and one a randomized controlled study. A total of 770 Dupuytren's hands, nearly all with Tubiana stage 0-1 disease, were irradiated with an average 30 Gy. Disease regression ranged from 0%-56%, stability from 14%-98% and progression from 2%-86%...
March 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28486091/angiotensin-receptors-in-dupuytren-s-disease-a-target-for-pharmacological-treatment
#9
Christopher Stephen, Leila Touil, Partha Vaiude, Jaipaul Singh, Stuart McKirdy
BACKGROUND: Attempts at the pharmacological treatment of Dupuytren's disease have so far been unsuccessful, and the disease is not yet fully understood on a cellular level. The Renin-Angiotensin System has long been understood to play a circulating hormonal role. However, there is much evidence showing Angiotensin II to play a local role in wound healing and fibrosis, with ACE inhibitors being widely used as an anti-fibrotic agent in renal and cardiac disease. METHODS: This study was designed to investigate the presence of Angiotensin II receptors 1 (AT1) and 2 (AT2) in Dupuytren's tissue to form a basis for further study into the pharmacological treatment of this condition...
May 9, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28473158/injectable-collagenase-versus-percutaneous-needle-fasciotomy-for-dupuytren-contracture-in-proximal-interphalangeal-joints-a%C3%A2-randomized-controlled-trial
#10
Simon Toftgaard Skov, Therkel Bisgaard, Per Søndergaard, Jeppe Lange
PURPOSE: Collagenase Clostridium histolyticum (CCH) injection was introduced commercially as a treatment for Dupuytren contracture following initial phase-3 investigations in 2009 with promising results. However, the efficacy of CCH has not been prospectively investigated in a direct comparison to other active treatments of Dupuytren contracture with more than 1-year follow-up, despite a wide and increasing clinical use. METHOD: In this prospective, independent, open-label, randomized controlled trial, (Clinicaltrials...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28444647/-partial-fasciectomy-and-options-of-reconstruction-using-local-flaps-in-cases-of-dupuytren-s-disease
#11
N Spindler, C Josten, S Langer
Aim: Partial fasciectomy in cases of grade III-IV Dupuytren's contracture and coverage of the defect with local flaps. Indication: Dupuytren's contracture is a progressive disease of the hand associated with the formation of fascial cords, which may result in flexion and adduction contractures of the fingers leading up to complete dysfunction of the hands. Method: If several fingers are affected, partial fasciectomy is the gold standard in the treatment of Dupuytren's contracture. Ideally, the fingers reach the neutral position after the fibres causing the contracture are resected and arthrolysis is performed as needed...
April 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28389081/the-use-of-residual-collagenase-for-single-digits-with-multiple-joint-dupuytren-contractures
#12
Louis C Grandizio, Anil Akoon, Janice Heimbach, Jove Graham, Joel C Klena
PURPOSE: Standard 0.58 mg (0.25 mL) collagenase Clostridium histolyticum (CCH) preparations result in unused CCH that is often discarded. Our purpose was to assess the results on Dupuytren contractures affecting both the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints in the same digit utilizing an injection containing the maximum CCH volume that can be withdrawn from a single vial. METHODS: A consecutive series of patients with MCP and PIP cords in the same digit received a single treatment with 2 injections totaling 0...
April 4, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28383356/-hills-plains-and-valleys-a-topographical-concept-in-the-treatment-of-dupuytren-s-contracture-with-needle-aponeurotomy
#13
Roshin Thomas, Emmett O'Flaherty
Needle aponeurotomy is emerging as a preferred choice of treatment for patients with Dupuytren's contracture keen on a quick, minimally invasive procedure that enables a rapid return of hand function. This article describes a unique topographical concept in the treatment of Dupuytren's contracture with needle aponeurotomy. This concept guides portal placement in a planned manner to achieve better correction and avoid potential complications.
June 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28382393/-dupuytren-s-disease-current-treatment-concepts
#14
EDITORIAL
Frank Unglaub, Christian K Spies
No abstract text is available yet for this article.
April 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28361190/-the-fibrous-skeleton-of-the-hand-changes-with-dupuytren-s-contracture
#15
M F Langer, J Grünert, F Unglaub, B Wieskötter, S Oeckenpöhler
The exact knowledge of the anatomy of the fibrous skeleton of the hand is an absolute prerequisite for any treatment of Dupuytren's disease. The fibrous skeleton does not only include the palmar aponeurosis, but also numerous retinacula cutis, which are not found in current anatomy books. Here, eponyms facilitate the otherwise difficult and over-pronounced names of the fiber systems. Skoog, Legueu and Juvara, Gosset, Grapow, Grayson, Cleland, Thomine, and Barton are the most important. This systematic review of the fibers and strands is designed to help reduce iatrogenic complications...
March 30, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28341067/treatment-of-recurrent-dupuytren-contracture-in-joints-previously-effectively-treated-with-collagenase-clostridium-histolyticum
#16
Brian J Bear, Clayton A Peimer, F Thomas D Kaplan, Gregory J Kaufman, James P Tursi, Ted Smith
PURPOSE: Collagenase Clostridium histolyticum (CCH) is approved for the treatment of adults with Dupuytren contracture with a palpable cord. This open-label, phase 4 study evaluated the safety and efficacy of CCH for the retreatment of recurrent contractures in joints that were previously effectively treated with CCH. METHODS: Patients participating in a long-term follow-up study who had contracture recurrence (increased ≥ 20° with a palpable cord) after successful treatment in the previous study were eligible...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28298365/collagenase-injections-for-dupuytren-s-disease-prospective-cohort-study-assessing-2-year-treatment-effect-durability
#17
Anna Lauritzson, Isam Atroshi
OBJECTIVES: To assess 2-year durability of joint contracture correction following collagenase injections for Dupuytren's disease. DESIGN: Prospective cohort study. SETTING: Orthopaedic Department in Sweden. PARTICIPANTS: Patients with palpable Dupuytren's cord and active extension deficit (AED) ≥30° in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joint. A surgeon injected 0.80 mg collagenase into multiple cord parts and performed finger manipulation under local anaesthesia after 24-48 hours...
March 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28280681/multiple-recurrences-in-aggressive-forms-of-dupuytren-s-disease-can-patients-benefit-from-repeated-selective-fasciectomy
#18
Sören Könneker, G Felix Broelsch, Nicco Krezdorn, Khaled Dastagir, Jörn W Kuhbier, Felix J Paprottka, Peter M Vogt
BACKGROUND: In Dupuytren's disease (DD), limited fasciectomy is the mainstay of surgical therapy in patients at risk of contractures and disease recurrences. New minimally invasive treatments such as injection of collagenase clostridium histolyticum have evolved as a common tool for the preliminary treatment of Dupuytren's contractures. However, recurrences and their therapy remain controversial. In this study, we evaluate the benefit of repeated limited fasciectomy in patients with aggressive forms of the disease and multiple recurrences of contractures...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28259564/modified-mccash-technique-for-management-of-dupuytren-contracture
#19
REVIEW
Alex C Lesiak, Nicole J Jarett, Joseph E Imbriglia
Despite recent advancements in the nonsurgical treatment for Dupuytren contracture, a number of patients remain poor nonsurgical candidates or elect for surgical management. The traditional McCash technique releases contractures while leaving open palmar wounds. Although successful in alleviating contractures, these wounds are traditionally large, transverse incisions across the palm. A modification of this technique has been performed that permits the surgeon to utilize smaller wounds while eliminating debilitating contractures...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28243691/-primary-intervention-in-dupuytren-s-disease
#20
U S Vesper, I M Mehling, A Arsalan-Werner, M Sauerbier
Partial aponeurectomy as the state-of-the-art treatment in Dupuytren's disease is indicated when minimally invasive forms of treatment, such as needle aponeurotomy or percutaneous collagenase injection, are not possible due to the advanced stage of the disease or the morphology of the contracture. Even in earlier stages of Dupuytren disease partial aponeurectomy has advantages in comparison to minimally invasive forms of treatment. These advantages are lower recurrence rates as well as less persistent residual contractures, especially in the proximal interphalangeal joint...
February 27, 2017: Der Orthopäde
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