Blog
Needle Aponeurotomy and Xiaflex compared
Xiaflex (Collagenase) has finally been approved by the FDA for the treatment of Dupuytren’s contracture. When work began on the development of collagenase to treat Dupuytren’s contracture, the bar was pretty low: anything better than fasciectomy in terms of either safety or efficacy would be a great advance. No other
Growing bent fingers straight
Two things are needed for people dealing with Dupuytren’s: a way to reverse or restore fingers back to their natural state and a way to prevent progression/recurrence. For the former, progress is being made; the latter remains the elusive goal of a cure. Dupuytren’s is a shrinking process. The ideal
Cellular biomechanics are the key to Dupuytren’s.
Dupuytren’s is truly a biomechanical process, and the ultimate process has to do with the way that fibroblasts and myofibroblasts attach to each other and physically attach to strands of collagen and other components of the tissue matrix which surrounds them. An investigation into the complex junction of living cells,
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
Frozen Shoulder, Dupuytren’s Cousin
Dupuytren’s contracture and frozen shoulder share similar biology and many people with one condition will eventually develop the other. Frozen shoulder differs from Dupuytren’s in that it is typically a painful condition with rapid onset, is more common in women and usually runs a limited course. It is similar in
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
Dupuytren’s and Associated Conditions
Dupuytren’s is associated with three conditions, Ledderhose, Peyronie’s and frozen shoulder. These all share a similar biology at a cellular level. Dupuytren’s is also associated with other conditions, such as diabetes, alcoholism, epilepsy, advanced HIV for reasons which are less clear. Is Dupuytren’s a risk factor for some of these
Genes, enzymes and Dupuytren’s: the alphabet name game.
A proteinase is an enzyme which breaks down proteins. Metalloproteinases (MPs) are proteinases with a molecular structure and function involves a metal atom, usually zinc. Matrix Metalloproteinases (MMPs) are MPs which act outside of cells, in the tissue matrix. Human collagenases are MMPs which break down different types of collagen.
LSD as a treatment for Dupuytren’s?
There is one published report of Dupuytren’s being cured, fingers suddenly straightened, under the influence of the psychedelic drug LSD (full text: https://dupuytrens.org/DupPDFs/1966_Solursh_1417.pdf). Is this true? Probably not. LSD is a serotonin antagonist, and other serotonin antagonist drugs, such as methysergide, have been shown to cause retroperitoneal and cardiac valve
Recent Dupuytren Publications
- 'Distal-to-proximal' surgical release of the proximal interphalangeal joint in Dupuytren's disease
- Collecting human remains in nineteenth-century Paris: the case of the Société Anatomique de Paris and the Musée Dupuytren
- C-X-C domain ligand 14-mediated stromal cell-macrophage interaction as a therapeutic target for hand dermal fibrosis
- Sensor-Controlled Patient Compliance with Postoperative Splinting after Dupuytren's Surgery
- Correspondence to: Henry O'Brien, Jay Paniker and Liam Brown: Is a smartphone application as accurate as a traditional goniometer for assessing finger joint angles in Dupuytren's disease? Hand Surg Rehabil 2023 Sep 29
