Search Our Scientific Publications & Authors

Hand (N Y) 2019 Jan 28:1558944718820955. Epub 2019 Jan 28.

1 Brigham and Women's Hospital, Boston, MA, USA.

Purpose: Range of motion (ROM) measurements of the fingers are frequently obtained during hand physical examinations. While traditionally measured by manual goniometry, smartphone photography introduces an alternative method of ROM measurement that also has potential telemedicine applications. The purpose of this study was to evaluate the reliability of smartphone photography measurements as an alternative to traditional goniometry, using the patient with Dupuytren disease as a model. Read More

ANZ J Surg 2019 Jan 26. Epub 2019 Jan 26.

Department of Orthopaedics, Gold Coast University Hospital, Southport, Queensland, Australia.

Background: Dupuytren's disease causes a flexion contracture of the hand that limits hand function and reduces quality of life. Traditional management is surgical excision which is associated with potentially serious complications. A viable alternative is collagenase Clostridium histolyticum (CCH) (Xiaflex®; Pfizer Australia) which is an effective, safe, outpatient treatment that to date has no published data in the Australian public health setting. Read More

Plast Reconstr Surg 2019 Jan 21. Epub 2019 Jan 21.

Background: The U.S. FDA approved collagenase Clostridium histolyticum (CCH) for treatment of Dupuytren contracture in 2010, and approved CCH for the concurrent treatment of up to two cords in 2014. Read More

Arch Orthop Trauma Surg 2019 Jan 23. Epub 2019 Jan 23.

Department of Plastic and Hand Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.

Introduction: Several studies have investigated the clinical outcome after collagenase treatment for Dupuytren's disease in terms of range of motion of the affected finger. However, good objective clinical outcome defined by a small remaining flexion contracture does not necessarily translate into satisfactory patient-subjective hand function. The aim of the present study was to identify predictors of patient-reported as well as objective clinical outcome in patients 1 year after collagenase treatment for Dupuytren's disease. Read More

Hand Surg Rehabil 2019 Jan 18. Epub 2019 Jan 18.

Centre de la Main, Angers assistance Main, Village Santé Angers Loire, 47, rue de la Foucaudière, 49800 Trélazé, France; CHU Tahar Sfar, avenue Tahar Sfar, 5100 Mahdia, Tunisia.

Severe contracture of the little finger due to Dupuytren's disease continues to be a therapeutic problem. Fifth finger amputation, which is sometimes the only solution, has a major negative impact on function and appearance, and exposes the patient to adjacent digital hook aggravation. Middle phalangectomy with finger shortening fusion is an alternative surgical solution. Read More

J Hand Surg Am 2018 Dec 18. Epub 2018 Dec 18.

Department of Orthopedic Surgery, Washington University, St Louis, MO. Electronic address:

Purpose: This study aimed to determine whether Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function and Pain Interference scores varied at presentation for specialty care by nontrauma hand condition. The secondary aim was to compare PROMIS scores with a reference standard, the Quick-Disabilities of the Arm, Shoulder, and Hand (QuickDASH), regarding the magnitude and direction of score differentials among diagnoses.

Methods: PROMIS Physical Function and Pain Interference scores were analyzed from 1,471 consecutive new adult patient clinic visits at a tertiary orthopedic hand clinic presenting with 1 of 5 nontrauma hand conditions. Read More

Plast Reconstr Surg 2018 Dec;142(6):1523-1531

Rotterdam and Utrecht, The Netherlands From the Department of Plastic and Reconstructive Surgery and Hand Surgery and the Department of Rehabilitation Medicine and Physical Therapy, Erasmus Medical Center; the Xpert Clinic, Hand and Wrist Center; and Handtherapie Nederland.

Background: In the Dupuytren Rotterdam randomized controlled trial, percutaneous aponeurotomy with lipofilling (PALF) was as effective as limited fasciectomy in correcting primary Dupuytren's contracture after 1 year. The authors report the 5-year results of this trial, with a special focus on recurrence of contractures.

Methods: The authors invited all patients who had undergone PALF or limited fasciectomy to participate in a posttrial follow-up assessment. Read More

Arch Plast Surg 2018 Nov 15;45(6):557-563. Epub 2018 Nov 15.

Department Plastic and Reconstructive Surgery, Countess of Chester Hospital NHS Foundation Trust, Chester, UK.

Background: Numerous Dupuytren's fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren's disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren's disease and unite current limited fasciectomy practice that varies considerably between surgeons. Read More

J Hand Surg Am 2018 Nov 9. Epub 2018 Nov 9.

Department of Plastic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. Electronic address:

Purpose: The aim of this study was to analyze the durability of the treatment results of the thumb and first web contractures in Dupuytren disease with collagenase Clostridium histolyticum.

Methods: Twelve patients (14 hands) were followed for an average of 35 months (range, 24-42 months). Two patients (3 hands) were excluded, yielding 11 hands available for assessment. Read More

J Hand Surg Asian Pac Vol 2018 Sep;23(3):336-341

* Department of Hand Surgery and Peripheral Nerve Surgery, Royal North Shore Hospital, Sydney Medical School, University of Sydney, Sydney, Australia.

Background: Dupuytren's disease results in contracted cords in the hand that lead to deformity and disability. Current treatment options include fasciectomy and an injectable, collagenase clostridium histolyticum. No cost comparison studies have been published within the Australian health care environment. Read More

J Hand Surg Asian Pac Vol 2018 Sep;23(3):437-439

* Department of Orthopedic Surgery, Kobe Rosai Hospital, Kobe, Japan.

We describe our injection method for Collagenase Clostridium Histolyticum using a medical silicone tube after determining the optimal depth by ultrasonography. This procedure adjusts the exposed needle length to the planned injection depth by placing a sterilized silicone tube over the needle. The restricted depth provides not only precise injection into the middle of the cords but also avoids needle tip migration through the cord and into the vital structures, which prevents possible complications. Read More

Arch Orthop Trauma Surg 2018 Nov 26;138(11):1623-1631. Epub 2018 Sep 26.

Department of Plastic- und Hand Surgery, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.

Introduction: In Switzerland, collagenase Clostridium histolyticum therapy (CCH) for Dupuytren's disease was introduced in 2011. This study analyzes possible differences between CCH and limited fasciectomy (LF) in terms of range of motion, patient satisfaction and postoperative rehabilitation.

Materials And Methods: This retrospective study included 52 patients with Dupuytren's disease stage 1-3 according to Tubiana, treated with CCH or LF between January 2012 and December 2013. Read More

Orthop Traumatol Surg Res 2018 Oct 2;104(6):901-905. Epub 2018 Jul 2.

University of Granada, Spain; Ophtalmologic Department, Hospital Virxen da Xunqueira, Cee, 15270 A Coruña, Spain.

Background: Collagenase clostridium histolyticum is now recognized as a viable treatment for Dupuytren disease. The high rate of adverse effects reported in patients continues to spark debate and raise questions about the true frequency of effects and their associated mechanisms of action.

Hypothesis: To investigate whether outcomes of CCH treatment are related to the number of adverse effects experienced. Read More

J Shoulder Elbow Surg 2018 Nov 6;27(11):e330-e336. Epub 2018 Sep 6.

Clinique du Mont Louis, Paris, France.

Background: This study evaluated the functional outcomes of bipolar pedicled pectoralis major (PM) transfer to restore elbow flexion.

Methods: We retrospectively reviewed 29 transfers in 28 patients with a mean age of 31.2 years (range, 5-65 years). Read More

J Hand Surg Am 2018 Aug 28. Epub 2018 Aug 28.

Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Groningen, Groningen, The Netherlands.

Purpose: Grayson ligament has been described as a common pathway for digital contracture in Dupuytren disease. Its anatomical descriptions in the literature are, however, inconsistent.

Methods: We have performed a microsurgical dissection study in 20 fresh-frozen and thawed digits to revisit the anatomy of Grayson ligaments. Read More

Bone Joint J 2018 09;100-B(9):1138-1145

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Aims: Dupuytren's contracture is a benign, myoproliferative condition affecting the palmar fascia that results in progressive contractures of the fingers. Despite increased knowledge of the cellular and connective tissue changes involved, neither a cure nor an optimum form of treatment exists. The aim of this systematic review was to summarize the best available evidence on the management of this condition. Read More

An Bras Dermatol 2018 Sep-Oct;93(5):773-774

Division of Internal Medicine, Santa Casa de São Paulo, São Paulo (SP), Brazil.

Plast Surg (Oakv) 2018 Aug 9;26(3):165-168. Epub 2018 Jan 9.

Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.

Purpose: Surgeons and resident physicians in a clinic setting often visually estimate Dupuytren flexion contractures of the hand to follow disease progression and decide on management. No previous study has compared visual estimates with a standardized instrument to ensure measurement reliability.

Methods: Consecutive patients consulted for Dupuytren flexion contractures of the hand had individual joint contractures estimated in degrees (°) by both a resident physician and staff surgeon. Read More

J Hand Surg Am 2018 Aug 23. Epub 2018 Aug 23.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Stony Brook Medicine, Stony Brook, NY.

Purpose: To explore the efficacy of injectable collagenase Clostridium histolyticum (CCH) in distal interphalangeal (DIP) joint contractures in Dupuytren disease.

Methods: A retrospective review was conducted for patients with DIP joint contractures treated with CCH. Baseline contracture and posttreatment residual contracture were recorded. Read More

Tech Hand Up Extrem Surg 2018 Sep;22(3):110-115

Department of Orthopedic Surgery, Kindai University Hospital, Osaka-sayama, Osaka.

Dupuytren's pathologic tissue usually involves the palmar skin and rarely infiltrates into the dorsal skin. In this study, we hypothesized that transplantation of a vascularized cutaneous flap harvested from the dorsum of the hand to the palmar skin, under which the pathologic cord existed might be useful for blocking reformation of the pathologic cords and for decreasing the recurrence rate. After removal of the pathologic tissue under the palmar skin, we harvested 2 types of skin islands nourished by the dorsal digital arterial network including the dorsal perforating arteries arising from the palmar digital arteries. Read More

Hand Surg Rehabil 2018 Oct 2;37(5):305-310. Epub 2018 Aug 2.

Hand surgery unit, department of orthopedic surgery 1, Trousseau University Hospital, Medical University François Rabelais of Tours, 37000 Tours, France. Electronic address:

The goal of this study was to assess the recurrence of Dupuytren's disease and the stability of the functional result after fasciectomy combined with the McCash open-palm technique. From 1989 to 1999, 56 consecutive patients were surgically treated for Dupuytren's disease. In 2003, 40 of these operated patients were reviewed by an independent evaluator; 12 patients were Tubiana stage 1, 16 stage 2, 9 stage 3 and 3 stage 4. Read More

J Hand Surg Eur Vol 2018 Oct 2;43(8):841-847. Epub 2018 Aug 2.

1 Department of Orthopedics, Odense University Hospital, Odense, Denmark.

This study assesses the joint-specific sustained effect of collagenase clostridium histolyticum treatment of Dupuytren disease over a 5-year follow-up period. The study includes 107 consecutive treatments in patients with extension deficits greater than 20° affecting the metacarpophalangeal or proximal interphalangeal joints. Success was defined as no follow-up treatment due to relapse or maintained extension deficit less than 20°. Read More

J Hand Surg Am 2018 Jul 25. Epub 2018 Jul 25.

Department of Orthopedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea. Electronic address:

Purpose: This study aimed to investigate the incidence and prognostic factors for prolonged postoperative symptoms after open A1 pulley release in patients with trigger finger, despite absence of any complications.

Methods: We reviewed 109 patients (78 single-finger involvement, 31 multiple-finger involvement) who underwent open A1 pulley release for trigger finger from 2010 to 2016, with 8 weeks or longer postsurgical follow-up and without postoperative complications. The group had 16 men and 93 women, with mean age of 56 years (range, 21-81 years), and average follow-up period of 24. Read More

J Plast Surg Hand Surg 2018 Jul 24:1-6. Epub 2018 Jul 24.

d Department of Translational Medicine, Division of Hand Surgery , Lund University , Jan Waldenströms gata 5 , Malmö , Sweden;

This post hoc analysis from a multicenter study (NCT01674634) was designed to evaluate the efficacy of collagenase Clostridium histolyticum (CCH) treatment in patients with different stages of Dupuytren contracture. Previously untreated patients who received two concurrent injections of CCH in two affected joints in the same finger were assessed by disease severity (Tubiana stage). The mean (SD) improvement in total fixed flexion contraction (FFC) 31 days post-CCH treatment in 181 patients was: 71. Read More

EBioMedicine 2018 08 18;34:14-15. Epub 2018 Jul 18.

Research Department, Shriners Hospitals for Children, Cincinnati, OH-45229, USA; Department of Pathology and Laboratory Medicine, University of Cincinnati, OH-45229, USA. Electronic address:

J Ultrasound Med 2019 Feb 19;38(2):387-392. Epub 2018 Jul 19.

Department of Radiology, University of Michigan, Ann Arbor, Michigan USA.

Objectives: To retrospectively characterize the ultrasound appearance of palmar fibromatosis in patients with a surgical or clinical diagnosis of palmar fibromatosis.

Methods: A search of ultrasound reports from 2005 to 2015 and a subsequent search of medical records were performed to identify patients with a surgical or clinical diagnosis of palmar fibromatosis. The ultrasound images were retrospectively reviewed to record the lesion location, size, echogenicity, compressibility, hyperemia, and calcification. Read More

Hand Clin 2018 08;34(3):xi

Michigan Medicine, University of Michigan Medical School, 2130 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0340, USA. Electronic address:

Hand Clin 2018 Aug;34(3):427-436

Department of Surgery, Michigan Medicine, University of Michigan Medical School, 2130 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.

As minimally invasive options for treatment of Dupuytren contractures become increasingly widespread, it is important that the evidence is carefully evaluated and patients are informed of the risks and benefits of the options available. The authors advocate a shared decision-making process, using evidence-based medicine, to guide patients in their treatment choices. In this article, the authors present their thoughtful approach to selecting the appropriate Dupuytren treatment of patients, along with detailed, practical technical tips to avoid complications during the execution of these interventions; both collagenase injection and limited fasciectomy techniques are described in detail. Read More

Hand Clin 2018 Aug;34(3):417-426

Hand and Wrist Surgery, Xpert Clinic, Rotterdam, The Netherlands; Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.

A comparison is provided between minimally invasive techniques and limited fasciectomy (LF) in the treatment of Dupuytren disease. A technique called percutaneous needle aponeurotomy and lipofilling is described. In a randomized controlled trial, there is no significant difference between this technique and LF after 1 year in contracture correction and recurrent contractures. Read More

Hand Clin 2018 Aug;34(3):403-415

Indiana Hand to Shoulder Center, 8501 Harcourt Road, Indianapolis, IN 46260, USA.

Treatment of recurrent Dupuytren disease is challenging. Multiple options exist, each having relative benefits and weaknesses. Choice for optimal treatment is made on a case-by-case basis, with shared decision making with the patient. Read More

Hand Clin 2018 Aug;34(3):395-401

Department of Hand Surgery, Plastic Surgery and Burns, Linköping University Hospital, Linköping University, Linköping 581 85, Sweden; Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, Norrköping 60174, Sweden. Electronic address:

The role of hand therapy in the treatment of Dupuytren disease varies depending on the patient and the procedure. There is limited evidence for hand therapy as a preventive treatment of Dupuytren disease. Before corrective treatment, the hand therapist can contribute with assessments to promote evaluation of outcome. Read More

Hand Clin 2018 08 8;34(3):387-394. Epub 2018 Jun 8.

Hand Surgery Service, Department of Orthopaedics, Yawkey Center, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. Electronic address:

Dupuytren contracture is a progressive disease involving collagen within the palmar fascia. When the contracture progresses to meet specific parameters, intervention is considered and includes collagenase injection, percutaneous or open fasciotomy, or palmar fasciectomy. Complications after treatment include contracture recurrence, digital nerve injury or postoperative neurapraxia, flexor tendon injury/rupture, delayed wound healing or skin necrosis, dysvascular digit/arterial injury, hematoma, and infection. Read More

Hand Clin 2018 08;34(3):377-386

Division of Plastic and Reconstructive Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, M1 500, Toronto, Ontario M4N 3M5, Canada. Electronic address:

Despite more than a hundred years of publications on Dupuytren disease, there has been a lack of consensus on definitions and outcomes until recently. Staging and classifications systems have an important historical context; however, more recently, outcomes rely on patient-reported outcomes, angular correction, and definitions of recurrence. This article reviews commonly used assessments, classifications, and staging systems for Dupuytren disease. Read More

Hand Clin 2018 08 8;34(3):367-375. Epub 2018 Jun 8.

Department of Orthopedic Surgery-Hand Unit, University Hospitals Leuven, University of Leuven, Herestraat 49, Leuven B-3000, Belgium.

Clinicians struggle with limited efficacy and durability of standard treatments when treating patients with Dupuytren disease diathesis. Alternative treatments such as low-dose radiation therapy in early phase of disease, supplemental pharmacotherapy with anti-inflammatory and/or anti-mitotic drugs, as well as other pharmacologic targets, and more aggressive surgery such as dermofasciectomy all have been reported with variable success or with serious side effects that hamper their standard use. This article gives an overview of the available literature. Read More

Hand Clin 2018 08;34(3):351-366

AToMS-Academic Team of Musculoskeletal Surgery, Undercroft, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, UK.

This article discusses limited fasciectomy for Dupuytren contracture, reviews the literature to list common complications, addresses the observations that need to be made after surgery, and systematically reviews the literature for 2 clinical questions: (1) regarding leaving wounds open and (2) the use of postoperative splintage. Read More

Hand Clin 2018 08;34(3):345-349

Department of Orthopaedics, T-18 Health Science Center, Stony Brook University Medical Center, Room 080, Stony Brook, NY 11794, USA.

Proof-of-principle, basic-science studies, using a rat-tail tendon model and surgically removed Dupuytren cords, began collagenase Clostridium histolyticum (CCH) development. Clinical studies in humans were then conducted, where the primary endpoint was reduction in contracture to within 0° to 5° of extension. Phase 2 studies, which confirmed the optimal dose of collagenase as 0. Read More

Hand Clin 2018 08;34(3):331-344

Division of Plastic Surgery, University of Alberta, 14310 111 Avenue Northwest, Edmonton, Alberta T5M 3Z7, Canada. Electronic address:

Needle aponeurotomy is an effective, minimally invasive treatment for metacarpophalangeal and interphalangeal joint contractures caused by Dupuytren disease. Multiple joints and digits can be safely treated in 1 session. Needle aponeurotomy is more cost-effective and has a significantly lower complication rate compared with open fasciectomy and collagenase injections. Read More

Hand Clin 2018 08;34(3):315-329

Department of Orthopedic Surgery and Division of Plastic and Reconstructive Surgery, Virginia Commonwealth University, Richmond, VA 23298, USA; Virginia Hand Center, 2819 N. Parham Road, Suite 100, Richmond, VA 23294, USA. Electronic address:

Dupuytren disease causes nodules and thickened fascial cords in the hands of affected individuals. In this article, the author explains normal fascial anatomy of the hand and describes how it relates to the pathologic anatomy found in Dupuytren disease. Anatomic findings in diseased cords are described, with particular reference to dangers encountered in treatment of this condition. Read More

Hand Clin 2018 08;34(3):307-314

Plastic Surgery & Laser Centre, Bedford Hospital NHS Trust, Reception J, Kempston Road, Bedford MK429DJ, UK. Electronic address:

Dupuytren disease (DD) is a benign, fibroproliferative disease of unknown cause. The disease predominantly affects the palms of the hands, causing permanent digital contracture of affected digits. DD is a late-onset disease and is often progressive, irreversible, and bilateral. Read More

Hand Clin 2018 08 8;34(3):301-305. Epub 2018 Jun 8.

Department of Plastic Surgery, University of Texas Southwestern Medical Center, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX 75216, USA.

Dupuytren disease is a fibroproliferative condition affecting the hands of millions of patients worldwide. The hypothesis of pathogenesis involves genetic factors and internal factors. Recent genome-wide association studies have provided much needed evidence for the long-held belief of a strong genetic component to the pathogenesis of Dupuytren disease. Read More

EBioMedicine 2018 Jul 6;33:282-288. Epub 2018 Jul 6.

Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, UK.

Background: Dupuytren's disease is a common fibrotic condition of the hand that causes irreversible flexion contractures of the fingers, with no approved therapy for early stage disease. Our previous analysis of surgically-excised tissue defined tumour necrosis factor (TNF) as a potential therapeutic target. Here we assessed the efficacy of injecting nodules of Dupuytren's disease with a TNF inhibitor. Read More

J Bone Joint Surg Am 2018 Jul;100(13):e91

J Bone Joint Surg Am 2018 Jul;100(13):1079-1086

Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.

Background: Local disruption of the cord that causes contracture of the finger in Dupuytren disease can be achieved either through mechanical division by percutaneous needle fasciotomy (PNF) or through enzymatic digestion by injectable collagenase Clostridium histolyticum (CCH). This study was designed to compare clinical and patient-reported outcomes between patients who had been treated with each method.

Methods: A prospective, randomized, single-blinded, controlled trial was designed and included 156 patients with a contracture of the metacarpophalangeal (MCP) joint of ≥20°. Read More

Zhongguo Gu Shang 2018 Jun;31(6):514-517

Department of Orthopaedics, Xin'an International Hospital of Zhejiang, Jiaxing 314000, Zhejiang, China;

Objective: To investigate the clinical efficacy of Pi needle percutaneous multi-segmental fasciotomy as a minimally invasive treatment for Dupuytren's contracture.

Methods: Sixteen patients(25 fingers: 4 middle fingers, 12 ring fingers, 9 little fingers) were involved in the study, including 11 males and 5 females. There were 2 cases on both hands and 14 cases of single hand disease, including 8 cases of left hand and 6 cases of right hand. Read More

PLoS One 2018 26;13(6):e0198326. Epub 2018 Jun 26.

Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Treatment for musculoskeletal fibromatosis remains challenging. Surgical excision for fibromatosis is the standard therapy but recurrence remains high. Corticosteroids, an anti-fibrogenic compound, have been used to treat early stage palmar fibromatosis, but the mechanism is unknown. Read More

Med Hypotheses 2018 Jul 17;116:40-41. Epub 2018 Apr 17.

Department of Plastic Surgery, Hand Surgery and Microsurgery, Friederikenstift, Hanover, Germany.

Dupuytren's disease, a benign fibroproliferative disorder of the palmar fascia, represents an ideal model to study tissue fibrosis. Transforming growth factor-β1 (TGF-β1) and its downstream Smad signaling system is well established as a keyplayer during fibrogenesis. Vitamin D has been extensively studied as an anti-fibrotic agent in malignant chronic diseases. Read More

J Plast Surg Hand Surg 2018 Aug 9;52(4):240-244. Epub 2018 May 9.

a Department of Radiology , Sahlgrenska University Hospital , Mölndal , Sweden.

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. Read More

Dan Med J 2018 May;65(5)

Introduction: The purpose of this study was to explore if there was a correlation between joint level and degree of contracture on the one hand and the risk of skin tear in Dupuytren's disease (DD) on the other, when treated with collagenase from Clostridium histolyticum. No trial or study has explored the risk of skin tear as primary outcome in a population that has not been treated for DD before.

Methods: A retrospective study of prospectively collected data was performed on patients with DD treated with collagenase from 1 August 2012 to 1 April 2014. Read More

J Hand Microsurg 2018 Apr 27;10(1):54-56. Epub 2017 Nov 27.

Department of Trauma and Orthopaedics, NHS Dumfries and Galloway, Dumfries and Galloway Royal Infirmary, Dumfries, Scotland.

The anatomy of the cords that form in Dupuytren's disease is complicated and a spiral cord is the most challenging variant to address. It displaces the neurovascular bundle toward or beyond the midline and closer to the skin. This article illustrates the surface anatomy of the neurovascular spiral to help surgeons identify this zone of danger that the authors term "the serpentine zone. Read More