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dupuytren treatment

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https://www.readbyqxmd.com/read/29741424/morphological-patterns-of-the-pretendinous-cord-in-dupuytren-s-disease-a-predictor-of-clinical-outcome
#1
P Vanek, J Strömberg, J Fridén, Y Aurell
The morphology of the pretendinous cord in Dupuytren's disease is poorly described in vivo and especially with respect to recurrence after treatment. This prospective study was designed to describe the morphology of Dupuytren's cords by ultrasound and to identify possible correlation between the ultrasonographic characteristics of these cords and the clinical outcomes two years after treatment. Thirty-nine patients with a contracture of at least 20° in the metacarpophalangeal (MCP) joint, who were scheduled for local treatment by either injectable collagenase clostridium histolyticum (CCH) or percutaneous needle fasciotomy (PNF), were examined by ultrasound...
May 9, 2018: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/29734007/collagenase-nanocapsules-an-approach-to-fibrosis-treatment
#2
María Rocío Villegas, Alejandro Baeza, Alicia Usategui, Pablo L Ortiz-Romero, José L Pablos, María Vallet-Regí
Fibrosis is a common lesion in different pathologic diseases and defined by the excessive accumulation of collagen. Different approaches have been used to treat different conditions characterized by fibrosis. The FDA and EMA approved the use of collagenase to treat palmar fibromatosis (Dupuytren's contracture). The EMA approved additionally its use in severe Peyronie's disease, but it has been used off label in other conditions.[1,2] The approved treatment includes up to three (in palmar fibromatosis) or up to eight (in penile fibromatosis) injections followed by finger extension or penile modeling procedures, typically causing severe pain...
May 4, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29706551/anesthesia-for-collagenase-clostridium-histolyticum-injection-in-patients-with-dupuytren-disease-a-cohort-analysis
#3
Rafael Sanjuan-Cerveró, Francisco J Carrera-Hueso, Pedro Vazquez-Ferreiro, Clayton A Peimer
Procedural pain is one of the most common adverse effects reported by patients with Dupuytren disease (DD) treated with collagenase clostridium histolyticum (CCH). The aim of this study was to assess the effectiveness of wrist block before CCH injection in reducing procedural pain and to analyze its impact on adverse effects. We performed a prospective, single-center study in which we compared two groups of patients in a consecutive cohort. In the first group (NO-BLOCK), wrist block was only performed before finger extension, whereas in the second group (BLOCK), it was performed before CCH injection and finger extension...
April 12, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29671703/my-40-year-perspective-on-hand-surgery
#4
Steven E R Hovius
The author presents his transition of his preferred methods for managing acute trauma and degenerative and congenital conditions of the hand. Based on his career-long experience, he discusses conceptual evolution and current status of treatment of Dupuytren's disease and several congenital anomalies of the hand.
May 2018: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29651852/current-treatment-options-of-dupuytren%C3%A2-s-disease
#5
J Kníže, J Miletín, A Nejedlý, M Chorvát, K Novotná, P Tichá, A Fibír, A Sukop, A Knížetová
Dupuytren's disease (fibromatosis of the palmar fascia, benign neoplastic fibromatosis, Dupuytren's contracture) is a disease characterized by growth and successive contracture of single parts of the palmar aponeurosis. This condition is known and has been treated for several centuries. In the advanced stages of the disease, it leads to significant limitation of hand function, resulting in reduced quality of life of the patient. Dupuytren's disease (DD) is a life-long disease with a variable course and a heterogeneous clinical presentation...
2018: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/29599391/dupuytren-treatment-effectiveness-trial-detect-a-protocol-for-prospective-randomised-controlled-outcome-assessor-blinded-three-armed-parallel-1-1-1-multicentre-trial-comparing-the-effectiveness-and-cost-of-collagenase-clostridium-histolyticum-percutaneous-needle
#6
Mikko P Räisänen, Teemu Karjalainen, Harry Göransson, Aleksi Reito, Hannu Kautiainen, Antti Malmivaara, Olli V Leppänen
INTRODUCTION: Dupuytren's contracture (DC) is a chronic fibroproliferative disorder of the palmar fascia which leads to flexion contracture in one or more fingers. There is no definitive cure for DC, and treatment aims at relieving symptoms by releasing the contracture using percutaneous or operative techniques. METHODS AND ANALYSIS: We planned a prospective, randomised, controlled, outcome assessor-blinded, three-armed parallel 1:1:1, multicentre trial comparing the effectiveness and cost of (1) collagenase clostridium histolyticum injection followed by limited fasciectomy in non-responsive cases, (2) percutaneous needle fasciotomy followed by limited fasciectomy in non-responsive cases and (3) primary limited fasciectomy during short-term and long-term follow-up for Tubiana I-III stages DC...
March 28, 2018: BMJ Open
https://www.readbyqxmd.com/read/29570549/skin-laceration-in-collagenase-clostridium-histolyticum-treatment-for-dupuytren-s-contracture
#7
Rafael Sanjuan-Cervero, Francisco J Carrera-Hueso, Salvador Oliver-Mengual, Maria A Ramon-Barrios, Clayton A Peimer, Narjis Fikri-Benbrahim
BACKGROUND: Dupuytren's contracture produces a progressive flexion contracture of the affected fingers. Collagenase Clostridium histolyticum produces breakdown of the cord in the hand and/or finger(s) that tightens as a result of the disease creating a contracture, allowing manual traction and cord rupture. One of the side effects is spontaneous skin laceration when the finger is extended. OBJECTIVES: To evaluate the development of skin lacerations in Dupuytren's contracture treated with collagenase Clostridium histolyticum, to determine predisposing factors, and evaluate the effectiveness of 2 different treatments (antiseptic and non-antiseptic dressings)...
March 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29535479/the-use-of-collagenase-clostridium-histolyticum-in-the-management-of-dupuytren-s-contracture-outcomes-of-a-pilot-study-in-a-district-general-hospital-setting
#8
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
https://www.readbyqxmd.com/read/29529955/hand-function-and-recurrence-after-limited-fasciectomy-for-dupuytren-s-contracture-long-term-follow-up
#9
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
https://www.readbyqxmd.com/read/29519629/one-year-follow-up-after-treatment-with-cch-for-dupuytren-s-disease-a-prospective-view
#10
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
https://www.readbyqxmd.com/read/29509625/the-impact-of-specialty-on-cases-performed-during-hand-surgery-fellowship-training
#11
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
https://www.readbyqxmd.com/read/29423783/peyronie-s-disease-and-dupuytren-s-contracture-secondary-to-topical-timolol
#12
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
https://www.readbyqxmd.com/read/29423145/management-of-abdomino-scrotal-hydrocele-ash-scrotal-inguino-retroperitoneal-sir-hydrocele-in-a-renal-transplant-patient
#13
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
https://www.readbyqxmd.com/read/29421069/technique-of-dynamic-flexor-digitorum-superficialis-transfer-to-lateral-bands-for-proximal-interphalangeal-joint-deformity-correction-in-severe-dupuytren-disease
#14
REVIEW
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
https://www.readbyqxmd.com/read/29370792/what-do-we-know-about-managing-dupuytren-s-disease-cost-effectively
#15
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
https://www.readbyqxmd.com/read/29317799/intra-articular-collagenase-injection-increases-range-of-motion-in-a-rat-knee-flexion-contracture-model
#16
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
https://www.readbyqxmd.com/read/29305454/efficacy-and-adverse-effects-of-collagenase-use-in-the-treatment-of-dupuytren-s-disease-a-meta-analysis
#17
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 ClinicalTrials.gov 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
https://www.readbyqxmd.com/read/29218326/study-protocol-a-multi-centre-double-blind-randomised-placebo-controlled-parallel-group-phase-ii-trial-ridd-to-determine-the-efficacy-of-intra-nodular-injection-of-anti-tnf-to-control-disease-progression-in-early-dupuytren-s-disease-with-an-embedded-dose-response
#18
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
https://www.readbyqxmd.com/read/29181346/phalangeal-fracture-during-attempted-dupuytrens-release-following-clostridial-collagenase-injection-case-report
#19
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
https://www.readbyqxmd.com/read/29157019/patients-needs-during-a-surgical-intervention-process-for-dupuytren-s-disease
#20
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
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