Dupuytren Contracture Procedure Choices
If a hand progresses from early Dupuytren disease (nodules, dimples, cords with no limitation of motion) to Dupuytren contracture, treatment should be considered. The best compromise between the ordeal of a procedure and the best long term outcome is to treat either when the finger is either awkwardly bent or if the bend of one joint […]
Options for Severe Dupuytren recontracture 1/2
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The worst and unsolved part of Dupuytren contracture is recontracture after treatment, and then recontracture after retreatment. Most people don’t have this problem, but when they do, the most common joint to have this problem is the small (pinky) finger PIP joint – the joint in the middle of the finger. Recontracture after a minimally […]
Dupuytren’s: it’s not just the fascia.
Dupuytren’s contracture is a local manifestation of a systemic process, and although the palmar fascia is the usual focus, what happens in the hand is a regional process, affecting the skin and the fatty layer under the skin as well as the fascia: it appears to be something which brews between the skin and the […]
Dermofasciectomy reconsidered
There are three mechanical approaches for Dupuytren’s. In order of both increasing problems and long term effectiveness, these are: fasciotomy (cut fascia); fasciectomy (remove fascia); dermofasciectomy (remove both skin and fascia). The popularity of dermofasciectomy and skin grafting has been limited by concerns regarding complications of wound healing and loss of flexion. Some of these […]