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dupuytren treatment

Lynn E Murphy, Karen M Murphy, Shauneen M Kilpatrick, Neville W Thompson
Introduction: Collagenase Clostridium Histolyticum (CCH) is a recognised treatment option for adult patients presenting with Dupuytren's contracture (DC). Patients and Methods: Twenty male patients with established DC were treated using CCH. The average metacarpophalangeal (MCP) joint and proximal interphalangeal joint (PIP) contractures pre-treatment were 520 (range, 0 - 750 ) and 350 (range, 0 - 840 ) respectively. The average DASH score pre-treatment was 24.2 points (range, 0 - 68...
May 2017: Ulster Medical Journal
Marko Bergovec, Josko Jelicic, Ana Oljaca, Ranko Bilic
PURPOSE: The aim of this study was to analyze long-term results after limited fasciectomy for Dupuytren's contracture. METHODS: The study included 34 patients (52 rays), with an average follow-up of 9.5 years (range: 7-13 years). Range of motion, functional status, recurrence, and complications were recorded. RESULTS: Preoperative metacarpophalangeal joint (MCPJ) contracture (median: 35°, range: 0-90°) improved postoperatively to full extension in all but one patient, with no recurrence at the most recent follow-up...
January 2018: Journal of Orthopaedic Surgery
R Sanjuán-Cerveró, P Vazquez-Ferreiro, D Gómez-Herrero, F J Carrera-Hueso, N Fikri-Banbrahim
Aim Clostridium histolyticum collagenase (CCH) is nowadays an alternative treatment for the contracture of Dupuytren. Our objective is to assess its effectiveness at one year in a series of consecutive patients. MATERIAL AND METHOD: Prospective study with minimum follow-up of one year. Evaluation of results and adverse effects. RESULTS: A total of 75 joints treated in 51 patients were included. The average age was 65.18years (SD: 7.288) and 82.7% were males. The initial mean contraction of the MCP was 34...
March 5, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Jason Silvestre, Joseph Upton, Benjamin Chang, David R Steinberg
BACKGROUND: Hand surgery fellowship programs in the United States are predominately sponsored by departments or divisions of orthopaedic surgery or plastic surgery. This study compares the operative experiences of hand surgery fellows graduating from orthopaedic or plastic surgery hand surgery fellowships. METHODS: Operative case logs of 3 cohorts of hand surgery fellows graduating during the academic years of 2012-2013, 2013-2014, and 2014-2015 were analyzed. The median case volumes were compared by specialty via Mann-Whitney U tests...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Huw Oliphant, Pieter Gouws
INTRODUCTION: Topical beta-blockers are a proven and safe medication used in the treatment of glaucoma and ocular hypertension. Local and systemic side effects are, however, well documented. Systemic side effects can include severe cardio-respiratory impairment, endocrine dysfunction, as well as headache and hyper-somnolence. Disorders involving fibrosis such as Peyronie's disease, Dupuytren's contracture, and retroperitoneal fibrosis are rarely described in the literature. CASE REPORT: We describe a case of a 55-year-old male patient undergoing treatment for ocular hypertension with topical timolol 0...
February 8, 2018: International Ophthalmology
Rohit Srinivasan, Martin Drage, Jonathon Olsburgh
Abdomino-scrotal hydrocele (ASH) is a very rare clinical entity. It is an unusual condition, in which there is an hourglass communication between a large hydrocele and the retroperitoneal space, through the inguinal canal. First described by Dupuytren in 1834 and defined by Bickle in 1919, the condition is rarely seen. Surgical management usually involves excision of the sac as the definitive treatment option. The pathogenesis of ASH remains unclear and numerous theories have been postulated. We favour the term scrotal-inguino-retroperitoneal (SIR) hydrocele as a more accurate description...
October 2017: Journal of Surgical Case Reports
Michael J Schreck, Hayden S Holbrook, L Andrew Koman
Pseudo-boutonniere deformity is an uncommon complication from long-standing proximal interphalangeal (PIP) joint contracture in Dupuytren disease. Prolonged flexion contracture of the PIP joint can lead to central slip attenuation and resultant imbalances in the extensor mechanism. We present a technique of flexor digitorum superficialis (FDS) tendon transfer to the lateral bands to correct pseudo-boutonniere deformity at the time of palmar fasciectomy for the treatment of Dupuytren disease. The FDS tendon is transferred from volar to dorsal through the lumbrical canal and sutured into the dorsally mobilized lateral bands...
February 2018: Journal of Hand Surgery
Melina Dritsaki, Oliver Rivero-Arias, Alastair Gray, Catherine Ball, Jagdeep Nanchahal
BACKGROUND: Dupuytren's disease (DD) is a common and progressive, fibroproliferative disorder of the palmar and digital fascia of the hand. Various treatments have been recommended for advanced disease or to retard progression of early disease and to prevent deterioration of the finger contracture and quality of life. Recent studies have tried to evaluate the clinical and cost-effectiveness of therapies for DD, but there is currently no systematic assessment and appraisal of the economic evaluations...
January 25, 2018: BMC Musculoskeletal Disorders
Kayleigh Wong, Guy Trudel, Odette Laneuville
Objectives: A knee joint contracture, a loss in passive range of motion (ROM), can be caused by prolonged immobility. In a rat knee immobilization flexion contracture model, the posterior capsule was shown to contribute to an irreversible limitation in ROM, and collagen pathways were identified as differentially expressed over the development of a contracture. Collagenases purified from Clostridium histolyticum are currently prescribed to treat Dupuytren's and Peyronie's contractures due to their ability to degrade collagen...
2018: Drug Design, Development and Therapy
R Sanjuan-Cerveró, F J Carrera-Hueso, P Vazquez-Ferreiro, M A Ramon-Barrios
AIMS: The aim of this meta-analysis was to assess the safety and efficacy of collagenase clostridium histolyticum compared with fasciectomy and percutaneous needle fasciotomy (PNF) for Dupuytren's disease. MATERIALS AND METHODS: We systematically searched PubMed, EMBASE, LILACS, Web of Science, Cochrane, Teseo and the registry for clinical trials and cohort or case-control studies which compared the clinical outcomes and adverse effects of collagenase with those of fasciectomy or PNF...
January 2018: Bone & Joint Journal
Jagdeep Nanchahal, Catherine Ball, Jennifer Swettenham, Susan Dutton, Vicki Barber, Joanna Black, Bethan Copsey, Melina Dritsaki, Peter Taylor, Alastair Gray, Marc Feldmann, Sarah Lamb
Dupuytren's disease is a common fibrotic condition of the hand affecting 4% of the population and causes the fingers to curl irreversibly into the palm. It has a strong familial tendency, there is no approved treatment for early stage disease, and patients with established digital contractures are most commonly treated by surgery. This is associated with prolonged recovery, and less invasive techniques have high recurrence rates.The myofibroblasts, the cells responsible for the excessive matrix deposition and contraction, are aggregated in nodules...
2017: Wellcome Open Research
Laura W Lewallen, Marco Rizzo
Introduction: Dupuytren's disease can be a challenging condition for both patients and surgeons. Injectable collagen clostridium histolyticum was approved for clinical use by the Food and Drug Administration in 2010. A number of side effects have been described. In this case report, we present a complication of a proximal phalanx fracture which occurred during attempted release post injection. To the best of our knowledge, this is the first reported case of this particular complication...
July 2017: Journal of Orthopaedic Case Reports
Christina Turesson, Joanna Kvist, Barbro Krevers
PURPOSE: To explore and describe clients' needs during a surgical intervention process for Dupuytren's disease. MATERIALS AND METHODS: Design: Interview study with 21 men undergoing surgical intervention for Dupuytren's disease. Qualitative content analysis was performed with the model of Patient Evaluation Process as a theoretical framework. RESULTS: The primary reason for seeking medical care was to receive an intervention to improve hand function...
November 21, 2017: Disability and Rehabilitation
Guy Feldman, Nimrod Rozen, Guy Rubin
Dupuytren's disease is a common benign fibromatosis of the palmar and digital fascia. The exact pathophysiology and epidemiology of this condition have not been entirely identified. Pathologic fibrous bands cause a flexion contracture of the metacarpal phalangeal joints and proximal interphalangeal joint. Treatment includes fasciectomy, needle fasciotomy, and enzymatic fasciectomy.
October 2017: Israel Medical Association Journal: IMAJ
Jessica Chisholm, Alison J Gareau, Stephanie Byun, Justin L Paletz, David Tang, Jason Williams, Terry LeVatte, Michael Bezuhly
BACKGROUND: Although surgical excision and intralesional collagenase injection are mainstays in Dupuytren disease treatment, no effective medical therapy exists for recurrent disease. Compound 21, a selective agonist of the angiotensin II type 2 receptor, has been shown to protect against fibrosis in models of myocardial infarction and stroke. The authors investigated the potential use of compound 21 in the treatment of Dupuytren disease. METHODS: Human dermal fibroblasts were treated in vitro with compound 21 and assessed for viability using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, migration by means of scratch assay, and profibrotic gene transcription by means of quantitative reverse transcription polymerase chain reaction...
November 2017: Plastic and Reconstructive Surgery
Chao Zhou, Steven E R Hovius, Adriana J Pieters, Harm P Slijper, Reinier Feitz, Ruud W Selles
BACKGROUND: Although the efficacy of collagenase clostridium histolyticum (CCH) injections has been demonstrated by randomized clinical trials, the relative effectiveness of CCH remains uncertain. Our aim was to compare the outcomes of CCH with those of percutaneous needle aponeurotomy (PNA) in daily clinical practice. METHODS: We analyzed data from patients undergoing PNA or CCH between 2011 and 2014 at 7 practice sites in the Netherlands. We examined the degree of improvement in contracture and adverse effects at 6-12 weeks after surgery or the last injection...
September 2017: Plastic and Reconstructive Surgery. Global Open
A Notarnicola, G Maccagnano, F Rifino, V Pesce, M F Gallone, I Covelli, B Moretti
Dupuytren’s disease is a debilitating disease of the hand characterized by nodules on the surface of the palm with progressive loss of finger extension. The chosen forms of treatment are infiltrative and surgical. Conservative treatment could be useful but few studies have been carried out and these regarded mainly stretching exercises and thermo-therapy. To date, no study has analyzed the effects of biostimulation with shock-waves (SW) and high energy laser therapy [Temperature controlled High Energy Adjustable multi-mode emission Laser (THEAL)]...
July 2017: Journal of Biological Regulators and Homeostatic Agents
Catherine McMillan, Celine Yeung, Paul Binhammer
PURPOSE: To examine agreement on Dupuytren disease (DD) treatment recommendations in an international sample of hand surgeons. METHODS: A survey was developed to determine expertise in needle aponeurotomy, surgery, and collagenase injection to treat DD and to examine treatment recommendations for 16 case scenarios. Case scenarios were predeveloped using expert input. Each case represented a unique combination of 4 dichotomous variables including cord thickness, contracture severity, patient age, and joint involvement...
December 2017: Journal of Hand Surgery
C Krefter, M Marks, S Hensler, D B Herren, M Calcagni
The objective of this study was to review the incidence of complications associated with different treatment options for patients with Dupuytren's disease. In a systematic literature review, the PubMed, EMBASE, Cochrane and Scopus databases were searched for clinical studies reporting complications after collagenase treatment, percutaneous needle fasciotomy (PNF), fasciectomy and dermofasciectomy. The incidence of complications was extracted from each study and stratified by procedure. From a total of 2251 references, 113 studies were analyzed and included with complication incidences varying from 0% to 100%...
October 2017: Hand Surgery and Rehabilitation
Michael Ng, Dipti Thakkar, Lorraine Southam, Paul Werker, Roel Ophoff, Kerstin Becker, Michael Nothnagel, Andre Franke, Peter Nürnberg, Ana Isabel Espirito-Santo, David Izadi, Hans Christian Hennies, Jagdeep Nanchahal, Eleftheria Zeggini, Dominic Furniss
Individuals with Dupuytren disease (DD) are commonly seen by physicians and surgeons across multiple specialties. It is an increasingly common and disabling fibroproliferative disorder of the palmar fascia, which leads to flexion contractures of the digits, and is associated with other tissue-specific fibroses. DD affects between 5% and 25% of people of European descent and is the most common inherited disease of connective tissue. We undertook the largest GWAS to date in individuals with a surgically validated diagnosis of DD from the UK, with replication in British, Dutch, and German individuals...
September 7, 2017: American Journal of Human Genetics
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