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dupuytren treatment

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https://www.readbyqxmd.com/read/28298365/collagenase-injections-for-dupuytren-s-disease-prospective-cohort-study-assessing-2-year-treatment-effect-durability
#1
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
#2
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
#3
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...
March 1, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28243691/-primary-intervention-in-dupuytren-s-disease
#4
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
https://www.readbyqxmd.com/read/28236563/a-clinical-trial-of-tension-and-compression-orthoses-for-dupuytren-contractures
#5
Annelien Brauns, Maarten Van Nuffel, Luc De Smet, Ilse Degreef
STUDY DESIGN: Randomized clinical trial on 2 patient groups with Dupuytren's disease. INTRODUCTION: Despite an unpredictable outcome, surgery remains an important treatment for Dupuytren's disease. Orthotic devices are a controversial noninvasive treatment method to influence the myofibroblasts in the nodules. PURPOSE OF THE STUDY: To detect how much improvement 2 types of orthotic device (tension and compression) as only treatment intervention can provide on a Dupuytren's contracture...
February 21, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28198773/early-post-operative-results-of-percutaneous-needle-fasciotomy-in-451-patients-with-dupuytren-disease
#6
Sanne Molenkamp, Tanneke A M Schouten, Dieuwke C Broekstra, Paul M N Werker, J Daniel Moolenburgh
BACKGROUND: Percutaneous needle fasciotomy (PNF) is a minimally invasive treatment modality for Dupuytren disease (DD). In this study we analyzed the efficacy and complication-rate of PNF using a statistical method that takes the multi-level structure of data, regarding multiple measurements from the same patients, into account. METHODS: The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy (PNF) were analyzed retrospectively...
February 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28183220/long-term-follow-up-of-dupuytren-disease-after-injection-of-triamcinolone-acetonide-in-chinese-patients-in-taiwan
#7
C-Y Yin, H-H M Yu, J-P Wang, Y-C Huang, T-F Huang, M-C Chang
Injection of triamcinolone acetonide is a non-operative treatment for early-stage Dupuytren disease in Caucasians, but its effectiveness in non-Caucasians is unclear. We report averaged 5-year follow-up results of 37 patients (49 affected hands) with early-stage Dupuytren disease for patients in Taiwan (non-Caucasian) who received a single dose of 5 mg triamcinolone acetonide injection into nodules monthly for 3 months. Using ultrasound, we recorded no progression of sizes of the modules following injection after 6 months...
February 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28181175/adverse-effects-of-collagenase-in-the-treatment-of-dupuytren-disease-a-systematic-review
#8
REVIEW
Rafael Sanjuan-Cerveró, Francisco J Carrera-Hueso, Pedro Vazquez-Ferreiro, Diego Gomez-Herrero
BACKGROUND: Collagenase clostridium histolyticum (CCH) has proven to be both safe and effective in the treatment of Dupuytren disease (DD). The medium-term outcomes are similar to those achieved with surgery, and most adverse effects are self-limiting and considered to be mild or moderate. OBJECTIVE: Our objective was to conduct a systematic review of the adverse effects of CCH in DD since the release of the drug to evaluate the incidence, severity, classification, and definitions of these effects...
February 8, 2017: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/28175957/-operative-treatment-of-dupuytren-s-contracture-arthrolysis-of-the-proximal-interphalangeal-finger-joint
#9
B Hohendorff, J Franke, C K Spies, F Unglaub, L P Müller, C Ries
BACKGROUND: In the operative treatment of Dupuytren's disease, in certain cases proximal interphalangeal joint flexion contracture remains after fasciectomy due to shrinkage, shortening, and/or adhesion of the periarticular structures. OBJECTIVES: How can a residual flexion contracture of the proximal interphalangeal joint after partial fasciectomy in Dupuytren's disease be treated surgically and what follow-up results can be expected? METHODS: Description of anatomy, indication, surgical technique of arthrolysis of the proximal interphalangeal joint, postoperative treatment, and critical analysis of the results reported in the literature...
February 7, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28175956/-percutaneous-needle-aponeurotomy-for-dupuytren-s-contracture
#10
J Oppermann, F Unglaub, L P Müller, S Löw, P Hahn, C K Spies
Dupuytren disease is a benign fibroproliferative disease of the palmar aponeurosis, which can cause considerable functional deficiencies for the person concerned. Partial aponeurectomy is the gold standard in primary surgery. Because it is minimally invasive and has short recovery and low complication rates, the importance of needle aponeurotomy under specific indications has been increasing in the last years. Needle aponeurotomy is a cost-effective treatment with low complication rates. The revision rate compared to partial aponeurectomy is higher...
February 7, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28160905/pain-associated-with-treatment-of-dupuytren-contracture-with-collagenase-clostridium-histolyticum
#11
Rafael Sanjuan-Cerveró, Francisco J Carrera-Hueso, Pedro Vazquez-Ferreiro, Narjis Fikri-Benbrahim, Nuria Franco-Ferrando, Clayton A Peimer
PURPOSE: The primary objective of this study was to quantify the degree of pain associated with collagenase Clostridium histolyticum (CCH) injection and to determine whether it is related to other factors in the intervention. METHODS: A prospective study of 135 patients was performed to evaluate pain at 3 points during treatment: (1) after CCH injection, using a numerical rating scale (NRS), (2) a binary (positive/negative) assessment before manipulation 24 hours after CCH and after removing the bandage, and (3) after joint manipulation performed with wrist block anesthesia...
February 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28160036/-treatment-of-recurrent-dupuytren-s-disease
#12
T Pillukat, L Walle, R Stüber, J Windolf, J van Schoonhoven
BACKGROUND: The tendency of recurrence or progression is a frequent problem in Dupuytren's disease. The management of recurrence is adapted to the individual situation and the patient's needs. In mild cases a non-operative approach is recommended. Revision surgery is reserved for disabling situations with acceptable circulation and sensation in absence of dystrophy. It is complicated by a combined formation of scar tissue and new cords. This increases the risk of soft tissue loss and injuries to the neurovascular bundles, which impair sensation and circulation and may result in loss of the finger...
February 3, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28138723/-treatment-of-dupuytren-s-disease-with-collagenase-clostridium-histolyticum
#13
M Keller, R Arora, G Schmiedle, T Kastenberger
BACKGROUND: Dupuytren's disease as a benign fibroproliferative disease leads to hyperplasia of the collagen fibers of the fascia of the palm, which can result in severe impairment of the functionality of the hand. OBJECTIVES: Examination of the significance of non-operative treatment of Dupuytren's disease with injectable collagenase clostridium histolyticum (CCH) METHODS: Observation of 120 patients treated with injectable collagenase. Documentation of the range of motion before the intervention, 12 months after the intervention, and documentation of any adverse events...
January 30, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28116281/dupuytren-s-disease-and-needle-aponeurotomy-rupture-of-a-deep-common-flexor-tendon-a-case-report-and-literature-review
#14
Salma Otayek, Jérôme Pierrart, Emmanuel H Masmejean
INTRODUCTION: The Percutaneous Needle Aponeurotomy (PNA) is a known and validated non-surgical treatment for Dupuytren's disease with a low rate of complications. Initially described for purely palmar forms, the indications extended to digital adhesions. Numerous surgeons remain hesitant about performing the PNA for digital treatment because of the risk of lesions in the noble structures. In literature, one complication is still rare, even non-existent, i.e. the tendon rupture. CASE PRESENTATION: We are reporting here the case of a rupture of the deep common flexor tendon, secondary to a needle aponeurotomy, for a recurring digital form in a 72-year-old woman...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28093015/prevalence-and-incidence-of-doctor-diagnosed-dupuytren-s-disease-a-population-based-study
#15
J Nordenskjöld, M Englund, C Zhou, I Atroshi
The prevalence and incidence of doctor-diagnosed Dupuytren's disease in the general population is unknown. From the healthcare register for Skåne region (population 1.3 million) in southern Sweden, we identified all residents aged ⩾20 years (on 31 December 2013), who 1998 to 2013 had consulted a doctor and received the diagnosis Dupuytren's disease (International Classification of Diseases 10th Revision code M720). During the 16 years, 7207 current residents (72% men) had been diagnosed with Dupuytren's disease; the prevalence among men was 1...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28027258/evidence-based-medicine-options-for-dupuytren-s-contracture-incise-excise-and-dissolve
#16
Keith A Denkler, Carolyn J Vaughn, Estelle L Dolan, Scott L Hansen
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Understand updates in the basic science, epidemiology, and treatment of Dupuytren's disease. 2. Understand treatment with needle aponeurotomy, collagenase, and fasciectomy. 3. Understand advanced needle techniques for Dupuytren's contracture. 4. Understand the safety and effectiveness of a new treatment, collagenase. SUMMARY: The literature on Dupuytren's disease encompasses many specialties...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27999467/the-bowstring-arch-bridge-analogy-to-guide-sequential-portal-placement-during-needle-aponeurotomy-in-the-treatment-of-dupuytren-contracture
#17
Roshin Thomas
No abstract text is available yet for this article.
December 2016: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/27760243/treatment-of-dupuytren-contracture-with-injectable-collagenase-within-the-veterans-affairs-system
#18
Stephen Duquette, Ryan Kuster, Tyler Evans, William Wooden, Imtiaz Munshi, Adam Cohen, Sunil S Tholpady
No abstract text is available yet for this article.
February 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27747514/collagenase-treatment-in-dupuytren-contractures-a-review-of-the-current-state-versus-future-needs
#19
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: Rheumatology and Therapy
https://www.readbyqxmd.com/read/27720205/a-novel-conformal-superficial-high-dose-rate-brachytherapy-device-for-the-treatment-of-nonmelanoma-skin-cancer-and-keloids
#20
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...
January 2017: Brachytherapy
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