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 2/2
The three traditional treatments for severe recurrent Dupuytren contracture are PIP joint fusion, dermofasciectomy and amputation. These have been reviewed here. The list of alternative approaches is growing, particularly for the most difficult problem of PIP joint recontracture. The problem is that over time, the tendons and ligaments of a bent PIP joint change and […]
2015 International Symposium on Dupuytren Disease
The May 2015 International Dupuytren Symposium in Groningen, The Netherlands was very productive. A textbook based on the proceedings is in the works. Video presentations are rolling out on http://Dupuytren.tv
Dupuytren Roundtable Discussions
Here are links to two recently published roundtable discussions by experts in the field of Dupuytren’s. Although these were discussions by surgeons for surgeons, they are really just conversations and quite readable. They highlight the current challenges both surgeons and their patients face with Dupuytren’s disease and provide insight into future efforts to develop a […]
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 […]
Fasciectomy: Unsafe at any Speed?
Fasciectomy, invented by Goyrand just a few years after Dupuytren’s initial demonstration of open fasciotomy, has been the main treatment option for Dupuytren’s for nearly 200 years. There have been many refinements, but the central theme of removing fascia is unchanged. With so much time and experience, one might assume that all of the wrinkles […]
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 […]
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 […]
