General

No advantage to open Proximal Interphalangeal Joint release for Dupuytren’s
By: Charles Eaton
Nov 24, 2009

Proximal interphalangeal joint contractures from Dupuytren’s disease take on a life of their own, persisting after the Dupuytren’s has been removed. One of the arguments for open fasciectomy is that PIP contractures can be treated by openly releasing the tight joint capsule and ligaments. Unfortunately, gains made in the operating room are lost during the […]

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Dupuytren’s and Burns
On: Nov 20, 2009
By: Charles Eaton

Dupuytren’s overlaps in some ways with the local excessive scarring which occur after a burn injury. This report documents the development of progressive Dupuytren’s disease developing in a young man after a hand burn, and reviews the conventional teachings regarding Dupuytren’s: http://www.dupuytrenfoundation.org/DupPDFs/2008_Balakrishnan_1422.pdf

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Gene Expression in Dupuytren’s
On: Nov 19, 2009
By: Charles Eaton

If Dupuytren’s is inherited, what are the genes involved? Difficult question. Every cell in a person’s body has the same genes, but every cell is not the same. The differences between cells are not from different genes, but from differences in gene expression: every cell in the body is like a tiny computer; chromosomes are […]

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ß-catenin, Wnt and Dupuytren’s
On: Nov 18, 2009
By: Charles Eaton

Ultimately, Dupuytren’s has to do with cell signalling: normal cells are somehow instructed (“signalled”) to become abnormal, and adjacent cells interact with each other in a progression of abnormal changes. One of the many ways that cell signal each other is the Wnt signaling pathway, which involves a series of proteins which trigger cascades of […]

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Chondroitin Sulfate, Dermatan Sulfate and Dupuytren’s
On: Nov 15, 2009
By: Charles Eaton

Dermatan sulfate is similar to the nutritional supplement chondroitin sulfate, and used to be called chondroitin sulfate. Dermatan sulfate is unusually abundant in fascia affected by Dupuytren’s. Is it the cause or is it the effect of the abnormal biology of Dupuytren’s? Maybe both, as discussed in this review: http://www.dupuytrenfoundation.org/DupPDFs/2007_Kozma.pdf

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Open fasciotomy for Dupuytren’s
On: Nov 14, 2009
By: Charles Eaton

 Patients with Dupuytren’s need two things, mechanical and biological. The former, a simple and safe way to straighten bent fingers, and the latter, a way to prevent disease progression and recurrence. This article reviews pros and cons of a simple mechanical treatment, open fasciotomy, for severe contractures in a group of elderly patients: http://www.dupuytrenfoundation.org/DupPDFs/2007_Jablecki.pdf

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Genetic determined biochemistry and Dupuyren’s
On: Nov 13, 2009
By: Charles Eaton

The genetic basis of Dupuytren’s is explained by the genetic basis of individual biochemistry and enzymatic variation. Sort of. This fascinating review shows how complicated this can be: http://www.dupuytrenfoundation.org/DupPDFs/2008_Zyluk.pdf

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Verapamil, tamoxifen, carnitine – options?
On: Nov 12, 2009
By: Charles Eaton

One resource for potential medical treatment of Dupuytren’s is the literature on medicines which work for related conditions such as Peyronie’s. This review examines the rationale and results of propionyl-L-carnitine, acetyl-L-carnitine, verapamil and tamoxifen in treating Peyronie’s disease. Is there a role for these in Dupuytren’s? http://www.dupuytrenfoundation.org/DupPDFs/2002_Cavallini.pdf

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Peyronie’s Disease and Dupuytren’s
On: Nov 9, 2009
By: Charles Eaton

Dupuytren’s is one manifestation of a systemic fibrotic disorder that can also show up as Ledderhose, frozen shoulder or Peyronie’s disease. Fortunately, the majority of people affected show only one of these conditions, but many have to deal with several or all of these. This summary reviews the condition referred to as Peyronie’s disease: http://www.dupuytrenfoundation.org/DupPDFs/2009_NIDDK.pdf

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CMMS therapy for stiffness after fasciectomy for Dupuytren’s
On: Nov 6, 2009
By: Charles Eaton

Stiffness is a common problem after fasciectomy, particularly loss of flexion, and can be resistant to stretching exercises or splints. This therapy program, incorporating a combination of casting and active exercises, helped patients regain motion when they had failed conventional hand therapy: http://www.dupuytrenfoundation.org/DupPDFs/2007_Rose.pdf

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