Blog
Dermofasciectomy reconsidered
There are three mechanical approaches for Dupuytren’s. In order of both increasing problems and long term effectiveness, these are: fasciotomy (cut fascia); fasciectomy (remove fascia); dermofasciectomy (remove both skin and fascia). The popularity of dermofasciectomy and skin grafting has been limited by concerns regarding complications of wound healing and loss
Matrix Metalloproteinases and Dupuytren’s
What are matrix metalloproteinases and how are they linked to Dupuytren’s? Matrix Metalloproteinases (MMPs) are naturally occuring enzymes whose name describes them: they are found outside cells in the extracellular matrix, their molecular makeup includes a metal (Zinc) and they break down proteins. Human collagenase, which breaks down collagen, is
Cortisone shots for Dupuytren’s nodules
Cortisone injections have been used for many years as an early treatment for Dupuytren’s in the nodular stage of involvement. This approach is based on clinical experience, but what is the actual biology? It may have to do with the finding that tissue matrix as well as the blood vessel
Botox and Dupuytren’s
The holy grail of treating Dupuytren’s contracture is “disease modification”: how to stop progression or recurrence in a safe, nontoxic way? Three articles hint at the tantalizing possibility of the use of Botox (botulinum toxin) for Dupuytren’s. Botox includes two classes of enzymes which affect two different biologic systems. The
Feedback Loops in Dupuytren’s
The best hope for finding a medical cure for Dupuytren’s and other fibrotic conditions is through a better understanding of abnormal cell signalling feedback loops regulating fibrosis. Cellular collagen metabolism regulation is not fully understood. Here are a few puzzle pieces. The protein transforming growth factor beta (TGF-ß), among other
The New Dupuytren Foundation Web site is live!
The Dupuytren Foundation has a new web site! It’s taken a lot of work, but the new web site for the Dupuytren Foundation is live. Looks nicer, works better, and more to come. http://DupuytrenFoundation.org
The Dupuytren Symposium is coming!
As tomorrow’s deadline for abstract submission nears, internet connections are heating up at command central for the 2010 International Symposium on Dupuytren’s Disease. The symposium syllabus looks very exciting, with some amazing new reports. Session topics have solidified as: The Myofibroblast; Genetics and Demographics; Disease Concepts; Collagen and Collagenase; Surgical
Dupuytren’s Review
Despite being a visible, obvious problem, Dupuytren’s is difficult to understand, like the Jimmy Buffet line “so simple – like the jitterbug – it plumb evaded me”. It is helpful to review the basics on a regular basis to keep a clear perspective. Here is a great review for hand
Needle Release of Dupuytren’s: 2010 Manual of Technique
Percutaneous fasciotomy for Dupuytren’s contracture is an old procedure, but was reinvented by Dr. Lermusiaux in Paris in the 1980s, who used a small needle rather than a scalpel. This modification allows the procedure to be performed using almost no anesthesia, which gives an unprecedented safety margin: the patient can
Recent Dupuytren Publications
- The Evidence for Perioperative Anesthetic Techniques in the Prevention of New-Onset or Recurrent Complex Regional Pain Syndrome in Hand Surgery
- Palmar Fibromatosis, Updated Review With Relationship to the A1 Pulley, Trigger Finger, and Presence of the Sonographic Comb Sign
- Treatment utilization for Dupuytren's contracture in the United States is influenced by socioeconomic factors
- Impact of Collagenase Injection on Dupuytren Disease Treatment in Japan: A Comprehensive Survey of Trends
- Ledderhose's Disease
