Orthop Traumatol Surg Res 2017 Jun 20. Epub 2017 Jun 20.

Service de chirurgie Plastique et chirurgie de la Main, CHU de 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

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

Hand (N Y) 2017 Jun 1:1558944717711461. Epub 2017 Jun 1.

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

Ann Plast Surg 2017 Jun 9. Epub 2017 Jun 9.

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

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

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

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

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

BMJ Open 2017 Mar 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

J Hand Surg Am 2017 May 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

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

J Hand Ther 2017 Feb 21. 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

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

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

J Hand Surg Am 2017 Feb;42(2):e109-e114

College of Human Medicine, Michigan State University, East Lansing; and the UP Health System-Marquette/Duke-LifePoint, Marquette, MI.

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.

Results: The average NRS for pain during infiltration was 4. Read More

Plast Reconstr Surg 2017 Jan;139(1):240e-255e

San Francisco, Calif. From the Division of Plastic Surgery, University of California, San Francisco.

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. Read More

J Hand Microsurg 2016 Dec 23;8(3):185-186. Epub 2016 Sep 23.

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

JAMA Surg 2017 Feb;152(2):204-205

Division of Plastic Surgery, Department of Surgery, Indiana University, Indianapolis2Division of Plastic Surgery, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana.

J Eur Acad Dermatol Venereol 2016 Oct 18;30(10):1694-1699. Epub 2016 Jul 18.

Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany.

Dupuytren's disease (DD) is a common fibroproliferative condition of the hand which tends to cause progressive digital flexion contracture. Therapeutic strategies to treat the disease include radiotherapy, injections of collagenase clostridium histolyticum, needle fasciotomy and extended surgical intervention dependent on involvement and duration of the disease. We have reviewed the literature with the aim to assess the conditions and effects of radiotherapy in DD. Read More

Rheumatol Ther 2016 Jun 3;3(1):43-51. Epub 2016 Feb 3.

Orthopedic Department, Hand Surgery, University Hospitals Leuven, Louvain, Belgium.

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). Read More

Acta Orthop Belg 2016 Aug;82(2):397-404

Dupuytren's disease is a connective tissue disorder leading to contractures. It can be treated surgically or through injections of collagenase Clostridium histolyticum (CCH). Patients with Dupuytren's contracture (> 20°) and a palpable cord were included in this observational study, aiming to characterise the Belgian patient population and to assess the effectiveness and safety of CCH. Read More

J Hand Surg Am 2016 Dec 18;41(12):e477-e479. Epub 2016 Sep 18.

Clinic of Plastic and Reconstructive Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.

Dupuytren disease in children younger than 10 years is rare and only 8 histologically proven cases have been reported. A histologically proven Dupuytren disease in a 10-year-old with an uncommon clinical presentation as a nodule on the radial side of the middle phalanx of the little finger is documented. Dupuytren's disease should be in the differential diagnosis in cases of nodules and contractures in the palm and fingers of children. Read More

Eur Rev Med Pharmacol Sci 2016 Sep;20(17):3688-91

Department of Orthopedic Surgery and Traumatology, Hospital de Denia, Denia - Alicante, Spain.

Objective: Secondary effects and drug reactions relative to collagenase Clostridium histolyticum treatment for Dupuytren's contracture are frequent. In only a few cases these secondary effects are considered serious. The mechanism that produces these effects of production is not well understood. Read More

Plast Reconstr Surg 2016 Sep;138(3):649-55

Rotterdam and Hilversum, The Netherlands From the Departments of Plastic, Reconstructive and Hand Surgery and Rehabilitation Medicine, Erasmus MC; and the Department of Hand and Wrist Surgery, Xpert Clinic.

Background: This study examined patient satisfaction with hand function after fasciectomy for Dupuytren's contracture and determined which preoperative patient- and disease-specific factors predicted this satisfaction.

Methods: Demographics and disease-specific factors were assessed from a prospective cohort of 194 patients who completed the Michigan Hand Outcomes Questionnaire preoperatively and underwent limited fasciectomy between 2011 and 2014 at six hand surgery practice sites. To evaluate satisfaction with hand function, patients were asked to complete the Michigan Hand Outcomes Questionnaire during the first year after fasciectomy. Read More

J Hand Surg Am 2016 Oct 18;41(10):963-968. Epub 2016 Aug 18.

Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA. Electronic address:

Purpose: The U.S. Food and Drug Administration approved the use of collagenase Clostridium histolyticum (CCH) in the United States in February 2010. Read More

Rev Med Chir Soc Med Nat Iasi 2016 Apr-Jun;120(2):244-51

This article contains bibliographical data concerning the rheumatic clinical manifestations in hypothyroidism: polyarthralgias, lack of recent skill of fine movements of the hands, carpal tunnel syndrome or tarsal, degenerative arthropathy or acute type (gout, chondrocalcinosis), adhesive capsulitis (frozen shoulder syndrome), generalized muscular stiffness, hypothyroid myopathy, secondary osteoarthritis, Dupuytren's contracture, "trigger finger" (also called as stenosing tenosynovitis or trigger thumb) etc. and data on the short history, epidemiology, of these disorders. Review include 60 bibliographical sources. Read More

J Hand Surg Am 2016 Sep 27;41(9):873-80. Epub 2016 Jul 27.

Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Gothenburg, Sweden.

Purpose: This study compared the efficacy of collagenase treatment and needle fasciotomy for contracture of the metacarpophalangeal (MCP) joint in Dupuytren disease.

Methods: This is a prospective, single-blinded, randomized study with follow-up 1 week and 1 year after treatment. One hundred and forty patients with an MCP contracture of 20° or more in a single finger were enrolled, of whom 69 patients were randomized to collagenase treatment and 71 patients to needle fasciotomy. Read More

J Hand Surg Am 2016 Sep 26;41(9):896-902. Epub 2016 Jul 26.

Department of Teaching, Research and Development, Schulthess Clinic, Zurich, Switzerland.

Purpose: The brief Michigan Hand Outcomes Questionnaire (briefMHQ) was developed as a shorter version of the Michigan Hand Outcomes Questionnaire (MHQ), but its measurement properties have not been investigated in patients with Dupuytren contracture. The objective of the study was to investigate the reliability, validity, responsiveness, and interpretability of the briefMHQ.

Methods: Fifty-seven patients diagnosed with Dupuytren contracture completed the briefMHQ as well as the full-length MHQ and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at baseline. Read More

J Hand Surg Asian Pac Vol 2016 Jun;21(2):187-92

1 Department of Orthopaedic Surgery, St. Olav's University Hospital, Trondheim.

Background: Our main goal was to see if treatment with collagenase injection is safe and effective and to assess patient satisfaction with this new treatment.

Methods: We prospectively followed 77 consecutive patients, treated for contracture in 91 fingers and 142 joints that received total of 109 collagenase injections. The patients were reviewed on the first and second day and at 4 and 12 months. Read More

Surg Innov 2016 Dec 22;23(6):557-562. Epub 2016 Jul 22.

University of Padua, Padua, Italy.

Purpose The purpose of this study is to examine the activity of collagenase from cultures of Vibrio alginolyticus as in vitro as in biological samples and to evaluate clinical perspectives of this product about the treatment of fibroproliferative diseases like Dupuytren's contracture. Methods The experimental part of the study has been divided in 2 stages. In the first stage, the collagenase has been produced in laboratory, assessing its purity, verifying the in vitro degradation of collagen by the enzyme and measuring the size of the fragments; in the second part, an experimental injection into samples of fibrous cord typical of Dupuytren's disease has been performed in vitro. Read More

Pol Przegl Chir 2016 May;88(3):160-2

Dupuytren's disease is typically observed in adults, in children and adolescents being rarely diagnosed. Only several cases were reported in children under the age of 10 years, including two infants under one year. There were no such reports in Polish literature. Read More

Plast Reconstr Surg 2016 Oct;138(4):837-46

Rotterdam and Hilversum, The Netherlands From the Departments of Plastic, Reconstructive, and Hand Surgery and Rehabilitation Medicine, Erasmus MC University Medical Center; and Hand and Wrist Surgery, Xpert Clinic.

Background: Percutaneous needle aponeurotomy is a less invasive surgical alternative to limited fasciectomy for Dupuytren's contracture, but appeared less efficacious in a previous randomized clinical trial. This study compared the effectiveness of both techniques in contemporary clinical practice.

Methods: The authors evaluated prospectively gathered data from all patients who were treated with percutaneous needle aponeurotomy or limited fasciectomy between 2011 and 2014 at six hand surgery practice sites in The Netherlands. Read More

Coll Antropol 2016 Apr;40(1):63-4

A proposition is made that when two independent traits show similar regional patterns of incidence among modern European regions, a plausible expectation is that these two, otherwise unrelated traits, have simultaneously been spread by migration of our ancestors. As a potential example for the proposed concept, distribution of patients with Dupuytren's contracture is here compared with the reported European distribution of Y-Chromosome Haplogroup I, a genetic marker linked to the last glaciation period. Read More

J Hand Surg Eur Vol 2016 Jul;41(6):667-8

Regional Burns & Plastic Surgery Unit, Whiston Hospital, Liverpool, UK.

J Dermatol Sci 2016 Aug 7;83(2):131-7. Epub 2016 May 7.

Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, CA, USA; Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, CA, USA; Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands. Electronic address:

Background: Dupuytren's Disease is a common disorder of the connective tissue characterized by progressive and irreversible fibroblastic proliferation affecting the palmar fascia. Progressive flexion deformity appears over several months or years and although usually painless, it can result in a serious handicap causing loss of manual dexterity. There is no cure for the disease and the etiology is largely unknown. Read More

J Plast Reconstr Aesthet Surg 2017 Jan 13;70(1):144-146. Epub 2016 May 13.

Royal Free Hospital, Hampstead, UK.

Plast Reconstr Surg 2016 Jun;137(6):1800-12

Rotterdam, The Netherlands; and Miami, Fla. From the Department of Plastic and Reconstructive Surgery and Hand Surgery, and the Department of Rehabilitation Medicine and Rijndam, Erasmus University Medical Center; and the Miami Hand Center.

Background: As an alternative to needle aponeurotomy release and limited fasciectomy treatment of Dupuytren's contracture, the authors introduced an extensive percutaneous aponeurotomy and lipofilling (PALF) procedure. In their previous study, the authors reported that contractures significantly improved and most patients returned to normal use of the hand within 2 to 4 weeks. To establish the safety and efficacy of PALF, the authors compared it to the standard limited fasciectomy in a single-blind, multicenter, prospective, randomized, controlled trial. Read More

Przegl Lek 2016 ;73(2):83-7

Introduction: Dupuytren's contracture is a progressive fibrosis of facial structures of the palmar surface of the hand, gradually leading to a reduction of its functions by impaired range of motion of fingers.

Materials And Methods: Clinical material consisted of 95 patients treated surgically in the Second Department of Surgery of the Jagiellonian University in 2006 - 2011 because of Dupuytren's contracture. Based on a study using PEM questionnaire (Patient Evaluation Measure) an assessment of the quality of life before and after surgery was made. Read More

J Hand Surg Eur Vol 2016 Jun;41(5):564

Tetbury, UK.

Br Med Bull 2016 Jun 5;118(1):149-58. Epub 2016 May 5.

Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84081 Baronissi, Salerno, Italy Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentirstry, Mile End Hospital, 275 Bancroft Road, London E1 4 DG, UK

Introduction: In the last few years, the use of collagenase clostridium histolyticum for management of Dupuytren's contracture has increased. The procedure of enzymatic fasciectomy has become popular because it is non-invasive, safe and fast to perform.

Sources Of Data: A systematic search was performed on Medline (PubMed), Web of Science and Scopus databases using the combined keywords 'Dupuytren collagenase' and 'Dupuytren clostridium histolyticum'. Read More

Plast Surg (Oakv) 2016 ;24(1):23-6

Hand Program, Trillium Health Partners, Toronto, Ontario.

Background: Night extension splinting has been used to treat patients with Dupuytren contracture to improve active range of motion (AROM) of the hand. A published case study demonstrated the benefit of splinting following needle aponeurotomy; however, no larger studies have evaluated the impact of postoperative splinting.

Objectives: To compare the impact of night extension splinting on AROM, specifically extension, following needle aponeurotomy for Dupuytren contracture. Read More

Arch Orthop Trauma Surg 2016 Jun 1;136(6):881-9. Epub 2016 Apr 1.

Department of Orthopaedics and Traumatology, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.

Introduction: To evaluate the efficacy of open partial aponeurectomy for recurrent Dupuytren's contracture.

Methods: Eighteen patients with recurrent Dupuytren's contracture of 22 fingers were retrospectively assessed with a mean follow-up time of 94 months (range: 70-114 months). Examination parameters included the determination of range of motion (ROM), grip strength, pain and subjective outcome (disabilities of the arm, shoulder and hand (DASH) questionnaire). Read More

Klin Khir 2015 Dec(12):61-5

Plast Reconstr Surg Glob Open 2016 Feb 26;4(2):e629. Epub 2016 Feb 26.

Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, Tex.; and Physical Medicine and Rehab, VA North Texas Healthcare System, Physical Medicine and Rehab Service, Dallas, Tex.

Unlabelled: Surgery remains the gold standard in the treatment of Dupuytren contracture but is technically demanding, carries significant risk of complications, and requires prolonged recovery time. Collagenase injection is an efficacious alternative to surgery; however, contracture release often requires multiple treatments spaced a month apart. We report our experience with a new collagenase treatment protocol aimed to minimize the total treatment time per joint contracture. Read More

Acta Ortop Bras 2016 Mar-Apr;24(2):98-101

. Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil.

Objective: : To evaluate and compare the behavior of glycosaminoglycans (GAGs) in Dupuytren disease (DD).

Methods: : This is an experimental study with 23 patients diagnosed with DD. Tissue collected through fasciectomy with incision type Brunner or McCash were evaluated by electrophoresis for identification of GAGs. Read More

J Ark Med Soc 2016 Jan;112(9):156-7

J Hand Surg Am 2016 Mar 21;41(3):348-53.e1. Epub 2016 Jan 21.

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

Purpose: To evaluate the short-term effectiveness of collagenase Clostridium histolyticum to treat thumb and first web contractures in Dupuytren disease.

Methods: We prospectively included 14 thumbs in 12 patients with a contracture at the metacarpophalangeal or interphalangeal joint of at least 20° with a palpable cord in the thumb (n = 8) or an adduction contracture of the thumb with palpable cords in the first web (n = 6). They received an injection containing 0. Read More

J Hand Surg Am 2016 Mar 16;41(3):354-61; quiz 361. Epub 2016 Jan 16.

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

Purpose: The course of Dupuytren disease (DD) is thought to be progressive; however, the course differs for each patient. The purpose of this study was to study the rate and pattern of progression of DD.

Methods: We prospectively analyzed the course of DD at intervals of 3 to 6 months in 247 Dutch participants with primary DD by measuring the surface area of nodules and cords and the total passive extension deficit. Read More