Flare reaction after fasciectomy for Dupuytren’s
Flare reaction refers to a disproportionate degree of swelling, pain and stiffness developing after surgery for Dupuytren’s contracture. Although commonly known, there is relatively little published on this. Flare shares some features with reflex sympathetic dystrophy, another poorly understood condition which is seen more often after Dupuytren’s surgery than other hand procedures. Flare reaction appears […]
Dupuytren’s and Associated Conditions
Dupuytren’s is associated with three conditions, Ledderhose, Peyronie’s and frozen shoulder. These all share a similar biology at a cellular level. Dupuytren’s is also associated with other conditions, such as diabetes, alcoholism, epilepsy, advanced HIV for reasons which are less clear. Is Dupuytren’s a risk factor for some of these other health issues or is […]
Genes, enzymes and Dupuytren’s: the alphabet name game.
A proteinase is an enzyme which breaks down proteins. Metalloproteinases (MPs) are proteinases with a molecular structure and function involves a metal atom, usually zinc. Matrix Metalloproteinases (MMPs) are MPs which act outside of cells, in the tissue matrix. Human collagenases are MMPs which break down different types of collagen. Membrane-type MMPs (MT-MMPs) are MMPs […]
LSD as a treatment for Dupuytren’s?
There is one published report of Dupuytren’s being cured, fingers suddenly straightened, under the influence of the psychedelic drug LSD (full text: http://www.dupuytrenfoundation.org/DupPDFs/1966_Solursh_1417.pdf). Is this true? Probably not. LSD is a serotonin antagonist, and other serotonin antagonist drugs, such as methysergide, have been shown to cause retroperitoneal and cardiac valve fibrosis. Based on this information, […]
FDA approves Collagenase for Dupuytren’s
Collagenase (Xiaflex) has been approved by the FDA for treatment of Dupuytren’s contracture, after years of intensive laboratory and clinical trials. Collagenase enzymatic fasciotomy is more similar to needle fasciotomy than to either open fasciotomy or fasciectomy in terms of rapid recovery and low complication rate. Compared to needle release, collagenase enzymatic fasciotomy should eventually […]
Dupuytren’s Genes
The hunt is on for the genetic basis of Dupuytren’s. A interesting analysis of the chromosome patterns found in Dupuytren’s tissue found a variety of genetic abnormalities and the unexpected finding that these variations were not found in the skin but were seen in areas of palmar fascia not usually involved with Dupuytren’s. (full text: […]
Luck and Dupuytren’s
Needle aponeurotomy for Dupuytren’s is not that new. It’s a new twist on the very first operation described for Dupuytren’s, percutaneous fasciotomy, which was performed by Cooper years before Dupuytren’s famous presentation. Adams wrote extensively about his results with percutaneous fasciotomy for Dupuytren’s in the late 1800s. Before Lermusiaux began using a needle for percutaneous […]
ß Catenin, Transforming Factor ß and Dupuytren’s
The physical changes associated with Dupuytren’s are similar to the process which heals open wounds through contraction and collagen production. Thanks to sophisticated laboratory research, the molecular controls for this process are beginning to be understood. See http://multimedia.mcb.harvard.edu/anim_innerlife.html for an amazing animation of how molecular cellular controls act like tiny physical machines. In Dupuytren’s, two […]
A Sampling of Patient Information Brochures on Dupuytren’s
What do health care providers think you should know or want to know about Dupuytren’s? Here is a sampling of patient information materials from the government http://dupuytrens.org/DupPDFs/2010_NHS-ptinfo.pdf, http://dupuytrens.org/DupPDFs/2010_OBS-ptinfo.pdf, organizations of hand surgeons http://dupuytrens.org/DupPDFs/2010_AAHS-ptinfo.pdf, http://dupuytrens.org/DupPDFs/2010_ASSH-ptinfo.pdf, http://dupuytrens.org/DupPDFs/2010_BSSH-ptinfo.pdf, individual physicians and hospitals http://dupuytrens.org/DupPDFs/2010_eHand-ptinfo.pdf, http://dupuytrens.org/DupPDFs/2010_KWO-ptinfo.pdf, http://dupuytrens.org/DupPDFs/2002_Hurst-ptinfo.pdf, http://dupuytrens.org/DupPDFs/2010_Lancashire-ptinfo.pdf and hand therapists http://dupuytrens.org/DupPDFs/2010_Kramer-ptinfo.pdf. Of course, a wide range of information is […]
Needle Aponeurotomy for Dupuytren’s
Needle aponeurotomy for Dupuytren’s contracture is a type of fasciotomy performed under local anesthesia. Compared to fasciectomy, it is less of an ordeal for the patient in terms of both procedure and recovery and has a lower complication rate. This report (full text: http://www.dupuytrenfoundation.org/DupPDFs/2008_Cheng_1610.pdf) reviews one group’s experience with needle aponeurotomy.
