Blog
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
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,
Dupuytren’s Genes
The hunt is on for the genetic basis of Dupuytren’s. A interesting analysis of the chromosome patterns found in Dupuytren’s tissue found a variety of genetic abnormalities and the unexpected finding that these variations were not found in the skin but were seen in areas of palmar fascia not usually
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
ß Catenin, Transforming Factor ß and Dupuytren’s
The physical changes associated with Dupuytren’s are similar to the process that heals open wounds through contraction and collagen production. Thanks to sophisticated laboratory research, the molecular controls for this process are beginning to be understood. In Dupuytren, two controls are ß Catenin and Transforming Factor ß. ß-catenin is a
Needle Aponeurotomy for Dupuytren’s
Needle aponeurotomy for Dupuytren’s contracture is a type of fasciotomy performed under local anesthesia. Compared to fasciectomy, it is less of an ordeal for the patient in terms of both procedure and recovery and has a lower complication rate. This report (full text: https://dupuytrens.org/DupPDFs/2008_Cheng_1610.pdf) reviews one group’s experience with needle
Recent Dupuytren Publications
- Discussion: Frequency and Reporting of Complications after Dupuytren Contracture Interventions: A Systematic Review and Meta-Analysis
- The effect of preoperative interventions on postoperative outcomes following elective hand surgery: A systematic review
- Palmoplantar keratoderma, knuckle pads, and syndactyly associated with a new missense variant in the SLURP1 gene
- Post-traumatic Dupuytren's contracture in a paediatric patient: a case report and literature review
- Collagenase injection versus limited fasciectomy surgery to treat Dupuytren's contracture in adult patients in the UK: DISC, a non-inferiority RCT and economic evaluation
