Partial Fasciectomy for Dupuytren’s
Dupuytren’s patients need two things: first, a way to prevent disease progression and recurrence; second, the simplest, safest way to straighten fingers bent by Dupuytren’s. While working and waiting on the first, there are choices for the second. One of these is limited or partial fasciectomy, which has the advantage of quick recovery and low […]
TGF-ß2 and Dupuytren’s
What if Dupuytren’s is due to slightly abnormal levels of a normal hormone, protein or other molecule in the system? If so, one of the most likely suspects would be Transforming Growth Factor Beta Two: TGF-ß2. This protein is part of the autocrine system (a chemical instant messaging system which lets individual cells communicate with […]
Deformity, aggressiveness and severity of Dupuytren’s
When is the most effective time to treat Dupuytren’s and what is the best treatment? These are not easy questions. Dupuytren’s responds differently and recurs differently in different people: starting with the same deformity (how bent the fingers are), people who do worse are described as having “aggressive” Dupuytren’s. Severity is a combination of the […]
Monkey model for Dupuytren’s
An experimental monkey model of Dupuytren’s Disease was performed to confirm or refute the microtrauma hypothesis of Dupuytren’s. The outcome: the reaction to rupture of the palmar fascia produced lesions identical to those of early Dupuytren’s, although did not lead to contractures during the period of study. The conclusion was that trauma is not the […]
Nice Overview of Dupuytren Disease
Time to pause and look at the big picture. Here is a balanced overview of the history, biology, etiology and epidemiology of Dupuytren Disease: https://dupuytrens.org/DupPDFs/2003_Thurston.pdf
The potential of cryotherapy and Dupuytren’s
Myofibroblasts are part of the normal tissue repair response to almost all injuries: cut, crush, burn, chemical injury, infectious gangrene, and others – with one exception: freeze injury. Freeze burns don’t contract, possibly because only in freeze injury, the original collagen matrix scaffold is preserved, which may inhibit myofibroblast formation: https://www.dupuytrens.org/DupPDFs/1984_Ehrlich.pdf. This makes cryotherapy a […]
Is Dupuytren’s work related?
A specific gene has not been definitively associated with Dupuytren’s, but the best evidence suggests that the primary cause is genetic. There are factors which alter risk, such as diabetes and local trauma, but these are minor compared with the underlying genetic risk. The question of causation is not simply academic: since the time of […]
Vitamin E treatment of Dupuytren’s Contracture
Treating Dupuytren’s with vitamin E. Does it work? No, according to this 50 year old study, documenting results with before and after plaster casts of the bent fingers. The results: no improvement in the degree of contracture. This is a pretty straightforward clearly documented study, which answers the question “Does three months of vitamin E […]
Not your typical Viking’s Dupuytren’s
In the Viking era, boats from what is now Denmark travelled west across the North Sea to invade what is now Great Britain, but boats from what is now Sweden travelled south across the Baltic Sea and took rivers deep into what is now southern Europe, where they may have left a genetic trail. This […]
Cell biology and faulty brakes in Dupuytren’s
TGF-beta is a protein which lets some cells boss other cells around. It’s manufactured and released by some cells, and other cells change what they are doing when they notice that TGF-beta is around. TGF-beta does different things to different cells, always in a domino effect. For example, fibroblasts respond to TGF-beta by accumulating the […]
