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 […]
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 […]
Personal experiences with Xiaflex and Needle Aponeurotomy
Xiaflex is now available, and is generating reports by both traditional writers and self published social media authors. There are now two minimally invasive treatments for contractures due to Dupuytren’s disease – Xiaflex injection and needle aponeurotomy – with relative advantages and disadvantages of each. The following video was made by a Dupuytren’s patient, documenting […]
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 […]
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 […]
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 […]
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 […]
