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    CURRENT TREATMENT OPTIONS OF DUPUYTREN´S DISEASE.
    Acta Chir Plast 2018 ;59(3-4):142-148
    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. Read More

    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 fasciotomy and limited fasciectomy as short-term and long-term treatment strategies in Dupuytren's contracture.
    BMJ Open 2018 03 28;8(3):e019054. Epub 2018 Mar 28.
    Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland.
    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. Read More

    One year follow-up after treatment with CCH for Dupuytren's disease: A prospective view.
    Rev Esp Cir Ortop Traumatol 2018 Mar 5. Epub 2018 Mar 5.
    Grupo de Investigación en Atención Farmacéutica, Cátedra de Atención Farmacéutica, Universidad de Granada, Granada, España.
    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. Read More

    Technique of Dynamic Flexor Digitorum Superficialis Transfer to Lateral Bands for Proximal Interphalangeal Joint Deformity Correction in Severe Dupuytren Disease.
    J Hand Surg Am 2018 Feb;43(2):192.e1-192.e6
    Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC.
    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. Read More

    The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome.
    Vojnosanit Pregl 2017 Jan;74(1):19-23
    Background/aim: Dupuytren’s disease is a progressive disease of the palmar and digital fascial structures, with functional limitations. There are no clear recommendations about the optimal time of surgical repair, concerning the hand impairment. The aim of our study was to investigate the relation between finger’s contracture degree and success of surgical treatment of the Dupuytren's disease. Read More

    Efficacy and adverse effects of collagenase use in the treatment of Dupuytren's disease: a meta-analysis.
    Bone Joint J 2018 Jan;100-B(1):73-80
    Hospital Dr Moliner, Porta Coeli s/n Serra, 46118, Valencia, Spain.
    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. Read More

    Safety and Effectiveness of Percutaneous Needle Fasciotomy for Dupuytren's Disease in the Palm.
    J Hand Microsurg 2017 Dec 8;9(3):115-119. Epub 2017 Aug 8.
    Department of Orthopaedics, University of Teesside, Middlesbrough, United Kingdom.
     Percutaneous needle fasciotomy is performed in the authors' department to treat Dupuytren's contracture at metacarpophalangeal joints. This study aimed to establish its safety and efficacy, compared with standard fasciectomy.  All patients who had this procedure performed over the study period were sent the validated British Society for Surgery of the Hand (BSSH) postal questionnaire assessing surgical outcome. Read More

    Effect of Compound 21, a Selective Angiotensin II Type 2 Receptor Agonist, in a Murine Xenograft Model of Dupuytren Disease.
    Plast Reconstr Surg 2017 Nov;140(5):686e-696e
    Halifax, Nova Scotia, Canada From the Department of Microbiology and Immunology and the Department of Surgery, Division of Plastic and Reconstructive Surgery, Dalhousie University; and the Izaak Walton Killam Health Centre.
    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. Read More

    Short-term effect of shockwave therapy, temperature controlled high energy adjustable multi-mode emission laser or stretching in Dupuytren’s disease: a prospective randomized clinical trial.
    J Biol Regul Homeost Agents 2017 Jul-Sep;31(3):775-784
    Course of Motor and Sports Sciences, Department of Basic Medical Science, Neuroscience and Sensory Organs, Faculty of Medicine and Surgery, University of Bari, Bari, Italy
    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. Read More

    Variation in Treatment Recommendations for Dupuytren Disease.
    J Hand Surg Am 2017 Dec 23;42(12):963-970.e6. Epub 2017 Sep 23.
    Division of Plastic and Reconstructive Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada. Electronic address:
    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. Read More

    A Genome-wide Association Study of Dupuytren Disease Reveals 17 Additional Variants Implicated in Fibrosis.
    Am J Hum Genet 2017 Sep;101(3):417-427
    Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, University of Oxford, Botnar Research Centre, Windmill Road, Oxford OX3 7HE, UK; Department of Plastic and Reconstructive Surgery, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, UK; NIHR Biomedical Research Centre, NDORMS, University of Oxford, Botnar Research Centre, Windmill Road, Oxford OX3 7HE, UK. Electronic address:
    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. Read More

    Real-Time Bioimpedance Sensing of Antifibrotic Drug Action in Primary Human Cells.
    ACS Sens 2017 Oct 19;2(10):1482-1490. Epub 2017 Sep 19.
    Burns Service of Western Australia, Royal Perth Hospital , Perth, Western Australia 6000, Australia.
    Fibrotic diseases are among the most serious health issues with severe burdens due to their chronic nature and a large number of patients suffering from the debilitating effects and long-term sequelae. Collagenase treatment is a nonsurgical option but has limited results. To date, there is no potent noninvasive solution for fibrosis. Read More

    Night Orthosis After Surgical Correction of Dupuytren Contractures: A Systematic Review.
    J Hand Surg Am 2017 Oct 1;42(10):839.e1-839.e10. Epub 2017 Sep 1.
    Division of Plastic and Reconstructive Surgery, College of Medicine, Dalhousie University, Halifax, Nova Scotia.
    Purpose: To determine the role of night orthosis use after surgical correction of Dupuytren contracture.

    Methods: We searched MEDLINE, EMBASE, CINAHL, AMED, OTSeeker, and CENTRAL for articles published from inception of the databases to August 2015. Assessment was undertaken by 2 independent reviewers (O. Read More

    Effectiveness of Conservative, Surgical, and Postsurgical Interventions for Trigger Finger, Dupuytren Disease, and De Quervain Disease: A Systematic Review.
    Arch Phys Med Rehabil 2017 Aug 30. Epub 2017 Aug 30.
    Department of General Practice, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.
    Objectives: To provide an evidence-based overview of the effectiveness of conservative and (post)surgical interventions for trigger finger, Dupuytren disease, and De Quervain disease.

    Data Sources: Cochrane Library, Physiotherapy Evidence Database, PubMed, Embase, and CINAHL were searched to identify relevant systematic reviews and randomized controlled trials (RCTs).

    Data Selection: Two reviewers independently applied the inclusion criteria to select potential studies. Read More

    Efficacy and safety of collagenase clostridium histolyticum for Dupuytren disease nodules: a randomized controlled trial.
    BMC Musculoskelet Disord 2017 Aug 30;18(1):374. Epub 2017 Aug 30.
    OrthoCarolina, 1915 Randolph Rd, Charlotte, NC, 28207, USA.
    Background: To determine the safety and efficacy of collagenase clostridium histolyticum (CCH) injection for the treatment of palmar Dupuytren disease nodules.

    Methods: In this 8-week, double-blind trial, palpable palmar nodules on one hand of adults with Dupuytren disease were selected for treatment. Patients were randomly assigned using an interactive web response system to receive a dose of 0. Read More

    Readability of online materials for Dupuytren's contracture.
    J Hand Ther 2017 Aug 23. Epub 2017 Aug 23.
    Department of Plastic Surgery, University of California Irvine, Orange, CA, USA.
    Study Design: Descriptive.

    Background: Dupuytren's contracture is a common disorder involving fibrosis of the palmar fascia. As patients are increasingly using online materials to gather health care information, it is imperative to assess the readability and appropriateness of this content. Read More

    Benefit of Local Anesthesia in Reducing Pain during Collagenase Injection for Dupuytren's Contracture.
    Plast Reconstr Surg 2017 Sep;140(3):565-569
    Hässleholm, Lund, Linköping, and Ängelholm, Sweden From the Department of Orthopedics, Hässleholm-Kristianstad Hospitals; the Department of Clinical Sciences-Orthopedics, Lund University; the Department of Medical and Health Sciences, Linköping University; and the Department of Orthopedics Aleris, Ängelholm Hospital.
    Collagenase injection for Dupuytren's contracture is commonly administered without anesthesia. The authors studied the benefit of injecting local anesthesia before collagenase in reducing treatment-related pain. This prospective cohort study included 187 patients (mean age, 69 years; 80 percent men) at two orthopedic departments in Sweden. Read More

    Dupuytren-Like Contracture of the Foot: Ledderhose Disease.
    Surg J (N Y) 2016 Jul 21;2(3):e102-e104. Epub 2016 Sep 21.
    Department of Plastic, Reconstructive, and Aesthetic Surgery, Selcuk University Medical Faculty, Konya, Turkey.
     Plantar fibromatosis is a rare hyperproliferative disease of plantar aponeurosis and is also called Ledderhose disease. Case properties and treatment are discussed in this report.  A 30-year-old man presented with painful bilateral plantar nodules. Read More

    Low second to fourth digit ratio in Dupuytren disease.
    Medicine (Baltimore) 2017 Aug;96(33):e7801
    aDepartment of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka bGakuen-minami Clinic, Nara, Japan.
    The ratio of the lengths of the second and fourth digits (2D:4D) has been described as reflecting endogenous prenatal androgen exposure. In general, 2D:4D is lower in men than in women and has potential as a biomarker or predictor for various diseases, athletic ability, and academic performance. Dupuytren disease has digital flexion contractures and is known to predominate in men, but the pathogenesis of the disease remains unclear. Read More

    The Hand of Sabazios: Evidence of Dupuytren's Disease in Antiquity and the Origin of the Hand of Benediction.
    J Hand Surg Asian Pac Vol 2017 Sep;22(3):403-410
    1 Department of Natural Sciences and Mathematics, West Liberty University, West Liberty, WV, USA.
    Dupuytren's disease gained its eponym from the surgeon Baron Guillaume Dupuytren (1777-1835). However, the terms "Cline's contracture" and "Cooper's contracture," named after the two surgeons who proposed the treatment for the palmar contractures prior to Dupuytren, have also been used to describe the disease. In addition to the eponyms attributed to these three surgeons, a number of other appellations with interesting provenance exist for Dupuytren's disease including the "Curse of the MacCrimmons," "Celtic hand," "Viking's disease," and the "Hand of Benediction. Read More

    Efficacy and safety of collagenase treatment for Dupuytren's disease: 2-year follow-up results.
    Hand Surg Rehabil 2017 Oct 18;36(5):346-349. Epub 2017 Jul 18.
    Orthopedic department, Monica hospital, 68, Harmoniestraat, 2018 Antwerp, Belgium.
    Dupuytren's contracture is a common hand problem that affects the palmar fascia. Several treatment options exist, but none are curative and recurrence is common. Bacterial collagenase has recently been proven beneficial for treating Dupuytren's disease, cleaving the collagen fibers at different sites, with weakening and eventually rupture of the fibrous cords after manipulation. Read More

    Preliminary results with non-centrifuged autologous fat graft and percutaneous aponeurotomy for treating Dupuytren's disease.
    Hand Surg Rehabil 2017 Oct 18;36(5):350-354. Epub 2017 Jul 18.
    Gaziosmanpaşa university, faculty of medicine, department of biostatistics, 60250 Tokat, Turkey. Electronic address:
    The aim of this study was to describe our experience with treating Dupuytren's disease using needle aponeurotomy and non-centrifuged autologous fat grafting. The study included 17 patients (18 hands). Patients were treated with needle aponeurotomy and non-centrifuged autologous fat graft under general anesthesia. Read More

    Dupuytren's contracture and handwork: A case-control study.
    Am J Ind Med 2017 Aug;60(8):724-733
    Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
    Objective: The objective of this study was to examine the association between Dupuytren's contracture (DC), repetitive handwork (RHW), heavy handwork (HHW), and/or vibration exposure.

    Methods: Frequency and intensity of the three types of handwork were collected and compared between DC patients and controls. Hours of work were weighted by average "frequency," for RHW, and average "intensity," for HHW and use of vibrating tool. Read More

    The Incidence of Complex Regional Pain Syndrome in Simultaneous Surgical Treatment of Carpal Tunnel Syndrome and Dupuytren Contracture.
    Hand (N Y) 2017 Jul 1:1558944717718345. Epub 2017 Jul 1.
    1 University of Louisville School of Medicine, KY, USA.
    Background: To determine the incidence of complex regional pain syndrome (CRPS) in the concurrent surgical treatment of Dupuytren contracture (DC) and carpal tunnel syndrome (CTS) through a thorough review of evidence available in the literature.

    Methods: The indices of 260 hand surgery books and PubMed were searched for concomitant references to DC and CTS. Studies were eligible for inclusion if they evaluated the outcome of patients treated with simultaneous fasciectomy or fasciotomy for DC and carpal tunnel release using CRPS as a complication of treatment. Read More

    Involvement of the Interosseous and Lumbrical Muscle-Tendon Units in the Lateral and Spiral Cords in Dupuytren's Disease of the Middle Fingers.
    Plast Reconstr Surg 2017 Jul;140(1):116-124
    Hamilton, Ontario, Canada From the Division of Plastic Surgery, Department of Surgery, and the Faculty of Health Science, McMaster University.
    Background: The nature of intrinsic muscle involvement in Dupuytren's disease of the middle fingers (long and ring) remains poorly characterized. Over the years, the authors have observed that both the spiral and lateral digital cords in the middle fingers receive contribution from intrinsic muscle-tendon units. This report describes the anatomical characteristics and frequency of intrinsic muscle-tendon unit involvement in Dupuytren's disease of the middle fingers. Read More

    Use of adipose tissue and stromal vascular fraction in hand surgery.
    Orthop Traumatol Surg Res 2017 Oct 20;103(6):927-932. Epub 2017 Jun 20.
    Service de chirurgie plastique et chirurgie de la main, CHU de Rouen, 1, rue de Germont, 76000 Rouen, France. Electronic address:
    Adipose tissue is an abundant source of various cell types including not only adipocytes, but also progenitor and endothelial cells from thestroma. Interest in adipose tissue has surged since the identification in 2001 of adipose-derived stem cells (ADSCs) and of the stromal vascular fraction (SVF) obtained from adipose tissue by enzymatic digestion and centrifugation. SVF has been proven effective in ensuring tissue regeneration, thus improving tissue trophicityand vascularisation. Read More

    Surgical treatment results for dupuytren's disease.
    Acta Ortop Bras 2017 May-Jun;25(3):71-73
    Metin Sabancı Baltalimanı Bone Diseases Training and Research Hospital, Department of Hand Surgery, Istanbul, Turkey.
    Objective: To present the results of our cases of Dupuytren's disease treated with regional selective fasciectomy in light of the literature.

    Methods: Patients diagnosed with Dupuytren's contracture and surgically treated with regional selective fasciectomy at our institution with adequate follow-up data were included in the study. All patients were routinely followed after surgery to assess results and complications. Read More

    Complications Following Collagenase Treatment for Dupuytren Contracture.
    Hand (N Y) 2017 Sep 21;12(5):NP148-NP151. Epub 2017 Jun 21.
    1 Oregon Health & Science University, Portland, USA.
    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. Read More

    Outcome of Dupuytren Contractures After Collagenase Clostridium Histolyticum Injection: A Single-institution Experience.
    Ann Plast Surg 2017 Aug;79(2):145-148
    From the *Plastic Surgery Specialists of South Florida, Hollywood; †Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Weston; and ‡School of Medicine, Florida Atlantic University, Boca Raton, FL.
    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. Read More

    Early Postoperative Results of Percutaneous Needle Fasciotomy in 451 Patients with Dupuytren Disease.
    Plast Reconstr Surg 2017 Jun;139(6):1415-1421
    Groningen, The Netherlands From the Department of Plastic Surgery, University of Groningen and University Medical Center Groningen; and the Department of Rheumatology, Medical Center Alkmaar.
    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. Read More

    Recurrence of Dupuytren's contracture: A consensus-based definition.
    PLoS One 2017 15;12(5):e0164849. Epub 2017 May 15.
    Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.
    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. Read More

    Injectable Collagenase Versus Percutaneous Needle Fasciotomy for Dupuytren Contracture in Proximal Interphalangeal Joints: A Randomized Controlled Trial.
    J Hand Surg Am 2017 May;42(5):321-328.e3
    Interdisciplinary Research Unit, Center for Planned Surgery, Silkeborg, Denmark; Orthopaedic Research Unit, Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark.
    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. Read More

    Reply: Percutaneous Aponeurotomy and Lipofilling (PALF) versus Limited Fasciectomy in Patients with Primary Dupuytren's Contracture: A Prospective, Randomized, Controlled Trial.
    Plast Reconstr Surg 2017 08;140(2):358e-359e
    Department of Plastic, Reconstructive, and Hand Surgery, Erasmus Medical Center, Rotterdam, The Netherlands Department of Plastic, Reconstructive, and Hand Surgery, Department of Rehabilitation Medicine at Rijndam, Erasmus Medical Center, Rotterdam, The Netherlands Department of Plastic, Reconstructive, and Hand Surgery, Erasmus Medical Center, Rotterdam, The Netherlands Miami Hand Center, Miami, Fla. Department of Plastic, Reconstructive, and Hand Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.

    The Use of Residual Collagenase for Single Digits With Multiple-Joint Dupuytren Contractures.
    J Hand Surg Am 2017 Jun 4;42(6):472.e1-472.e6. Epub 2017 Apr 4.
    Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA.
    Purpose: Standard 0.58 mg (0.25 mL) collagenase Clostridium histolyticum (CCH) preparations result in unused CCH that is often discarded. Read More

    "Hills, Plains, and Valleys": A Topographical Concept in the Treatment of Dupuytren's Contracture With Needle Aponeurotomy.
    Tech Hand Up Extrem Surg 2017 Jun;21(2):55-59
    Dumfries and Galloway Royal Infirmary, Dumfries, Scotland, UK.
    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. Read More

    [The fibrous skeleton of the hand : Changes with Dupuytren's contracture].
    Orthopade 2017 Apr;46(4):303-314
    Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstr. 1, 48149, Münster, Deutschland.
    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. Read More

    Treatment of Recurrent Dupuytren Contracture in Joints Previously Effectively Treated With Collagenase Clostridium histolyticum.
    J Hand Surg Am 2017 May 22;42(5):391.e1-391.e8. Epub 2017 Mar 22.
    Endo Pharmaceuticals Inc., Malvern, PA.
    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. Read More

    Acute Gout Following Dermofasciectomy in a Patient With Dupuytren Disease.
    J Hand Surg Am 2017 Jan 27;42(1):e49-e50. Epub 2016 Oct 27.
    Sheffield Hand Unit, Northern General Hospital, Sheffield, United Kingdom.
    A 62-year-old man underwent uncomplicated dermofasciectomy of the right little finger. In the week after surgery, he presented with erythema, tenderness, reduced range of movement, and a chalklike discharge from the suture line. Investigations revealed a raised serum urate level accompanied with a borderline rise in inflammatory markers. Read More

    Collagenase injections for Dupuytren's disease: prospective cohort study assessing 2-year treatment effect durability.
    BMJ Open 2017 03 15;7(3):e012943. Epub 2017 Mar 15.
    Department of Orthopedics, Hässleholm-Kristianstad-Ystad Hospitals, Hässleholm, Sweden.
    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. Read More

    Modified McCash Technique for Management of Dupuytren Contracture.
    J Hand Surg Am 2017 05 1;42(5):395.e1-395.e5. Epub 2017 Mar 1.
    Hand and Upper Extremity Center, Wexford, PA.
    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. Read More

    [Primary intervention in Dupuytren's disease].
    Orthopade 2017 Apr;46(4):336-341
    Abteilung für Plastische-, Hand- und Rekonstruktive Chirurgie, BG-Unfallklinik Frankfurt am Main, Friedberger Landstraße 430, 60389, Frankfurt am Main, Deutschland.
    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. Read More

    A clinical trial of tension and compression orthoses for Dupuytren contractures.
    J Hand Ther 2017 Jul - Sep;30(3):253-261. Epub 2017 Feb 21.
    Orthopaedic Department, Hand Unit, University Hospitals Leuven, Pellenberg Campus, Pellenberg, Belgium.
    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. Read More

    Adverse Effects of Collagenase in the Treatment of Dupuytren Disease: A Systematic Review.
    BioDrugs 2017 Apr;31(2):105-115
    University of Granada, Granada, Spain.
    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. Read More

    [Epidemiology of Dupuytren's disease].
    Orthopade 2017 Apr;46(4):298-302
    Handchirurgie, Vulpius Klinik, Vulpiusstr. 29, 74206, Bad Rappenau, Deutschland.
    Dupuytren's disease is a chronic disease of the elderly. Assuming that life expectancy will increase considerably in the coming decades, Dupuytren's disease will gain more medical and socioeconomic relevance. In addition to well-known familial and genetic causes, other environmental factors (nicotine, diabetes, alcohol, trauma, work) are discussed. Read More

    [Operative treatment of Dupuytren's contracture : Arthrolysis of the proximal interphalangeal finger joint].
    Orthopade 2017 Apr;46(4):328-335
    Unfall-, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum zu Köln, Köln, Deutschland.
    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.

    Results: Arthrolysis of the proximal interphalangeal joint is performed in up to six consecutive steps. Read More

    [Percutaneous needle aponeurotomy for Dupuytren's contracture].
    Orthopade 2017 Apr;46(4):315-320
    Abteilung für Handchirurgie, Vulpius Klinik Bad Rappenau, Vulpiusstraße 29, 70906, Bad Rappenau, Deutschland.
    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. Read More

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