When is the most effective time to treat Dupuytren’s and what is the best treatment? These are not easy questions. Dupuytren’s responds differently and recurs differently in different people: starting with the same deformity (how bent the fingers are), people who do worse are described as having “aggressive” Dupuytren’s. Severity is a combination of the measure of deformity and an estimate of aggressiveness. Genes determine whether or not someone will develop Dupuytren’s and to a degree how aggressive it will be. External factors, such as alcoholism, amplify aggressiveness. Optimum treatment would be individualized based on severity, but a standard evaluation of all available factors is needed. This report analyzes a new system for estimating severity of Dupuytren’s: http://www.dupuytrenfoundation.org/DupPDFs/2008_Hindocha_1014.pdf
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