General

Sex and Dupuytren’s in Boston
By: Charles Eaton
Dec 13, 2009

Dupuytren’s is fairly common in Boston, but seems different than the European flavor in terms of sex. The numbers on almost 2000 Boston Dupuytren’s patients were sorted out, and here’s how things roll in Boston: men develop Dupuytren’s almost twice as often as women, but it may seem like more because men tend to get […]

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Looking at Dupuytren’s with MRI
On: Nov 29, 2009
By: Charles Eaton

Where is Dupuytren’s? It’s been known for some time that Dupuytren’s involvement can be identified by MRI, as described in these articles:http://www.dupuytrenfoundation.org/DupPDFs/1993_Yacoe_813.pdfhttp://www.dupuytrenfoundation.org/DupPDFs/1994_Miller.pdfand it’s likely that the activity of the process could be mapped, both for predictive value and for targeted treatment to prevent progression. Now, these papers are 15 years old – it’s time to […]

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The Fish Technique for Dupuytren’s: Fasciectomy and Skin Graft
On: Nov 27, 2009
By: Charles Eaton

Skin grafts are used in a variety of approaches for Dupuytren’s: to add skin where it has been shortened (fasciotomy and skin graft, fasciectomy and skin graft); to replace skin where it has been removed to prevent recurrence (dermofasciectomy and skin graft). This study reviews the results of fasciectomy and skin graft. The recurrence rate […]

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Accidental fasciotomy for Dupuytren’s
On: Nov 25, 2009
By: Charles Eaton

Fingers bent by Dupuytren’s can complicate a fall on an outstretched hand: because the fingers can’t stretch back, the force of impact is redistributed, making it more likely to break hand bones. When the fall is hard enough to break something, occasionally what gives is not bone, but the Dupuytren cord. This usually is accompanied […]

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

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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