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: http://www.dupuytrenfoundation.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 […]
Oxygen Free Radicals and Dupuytren’s
Oxygen free radicals affect Dupuytren’s fibroblasts: high levels are toxic, but not only do slightly elevated levels stimulate fibroblast activity, active fibroblasts actually produce oxygen free radicals. Which is the chicken and and which is the egg? This seminal paper reports studies of the effects of oxygen free radicals on Dupuytren and normal fibroblasts, the […]
Viking blood, blue eyes and other risk factors for Dupuytren’s
What is the actual story of the Vikings and Dupuytren’s? The full history will never be known, but some fascinating details on this and other risk factors, including blue eyes, are reviewed here: http://www.dupuytrenfoundation.org/DupPDFs/2001_Flatt_1397.pdf. See page 4 for a decision tree showing how to predict the risk of recurrence after surgery based on family history, […]
Sorting out the truth
Don’t believe everything you read about Dupuytren’s – even in respectable journals. I was aware that reflex sympathetic dystrophy (complex regional pain syndrome) was more common after fasciectomy for Dupuytren’s than for other hand operations, but there is little published on this. Then, this report came out documenting surprisingly high incidence of this complication, higher […]
Lessons from Peyronie’s for Dupuytren’s
Peyronie’s disease is more common than Dupuytren’s – 3 to 9 percent of the population – and shares a similar biology and genetic predisposition. Progress in the treatment of Peyronie’s will benefit that of Dupuytren’s and vice versa. Taken in this context, these two articles by Hellstrom from 2000 and 2009 are very thought provoking. […]
Stretching may provoke Dupuytren’s
The relationships between mechanical forces and the biochemistry of Dupuytren’s are only recently being sorted out. Clinically, Dupuytren’s activity responds to changes in mechanical stresses: active nodules soften in response to reducing tension by adjacent fasciotomy; disease activity after fasciectomy may be provoked by overly aggressive stretching and splinting. Biochemically, this may relate to the […]
