Blog
How the FDA sees Collagenase for Dupuytren’s
Why is it taking so long for collagenase injection treatment to be available to treat Dupuytren’s? Trials have been ongoing for over 10 years. The answer: collagenase is an extremely potent substance, and the FDA has required very detailed proof not only that it works, but that it is safe,
Abstracts can be misleading
Unlike proximal interphalangeal joint contractures from Dupuytren’s, metacarpophalangeal joint contractures usually respond so well to fasciectomy or fasciotomy that joint capsule or ligament release is generally not a consideration. Because of this, I was intrigued by the title of this report: a series of patients treated with dermofasciectomy and MP
Myofibroblast Biology
Myofibroblast biology is at the heart not only of Dupuytren’s, but of other diseases not related to Dupuytren’s. Myofibroblasts are major players in pulmonary fibrosis, cirrhosis, renal fibrosis and arteriosclerosis. Studies of myofibroblast biology in these conditions may shed light on potential new treatment strategies for Dupuytren’s. Gains in the
Pregnancy, Dupuytren’s and Relaxin
Relaxin is a natural hormone which does many things and normally increases during pregnancy. It has been shown to have a range of antifibrotic actions: it inhibits collagen synthesis, increases collagenase activity, inhibits the profibrotic factors TGFß and Interleukin1-ß, and prevents fibroblast differentiation into myofibroblasts. How does it work? Is
A Surgeon’s Perspective of Dupuytren’s
A very readable review of Dupuytren’s Disease from a surgeon’s perspective: https://www.dupuytrens.org/DupPDFs/1985_Hill.pdf
To understand Dupuytren’s, first understand women.
Is Dupuytren’s a tumor – an independent growth, or is it a reaction of normal tissues to a stimulus? Is a woman one person or several people sharing the same body? This paper answers both questions. Every female human has two X chromosomes, one from each parent, but in any
Fasciotomy versus fasciectomy for Dupuytren’s
Fasciectomy and fasciotomy were compared in this study with some interesting observations. Initially after procedure, fasciotomy was better than fasciectomy in straightening fingers, but this advantage was lost over time as fasciotomy had earlier recurrences than fasciectomy. Fasciectomy had better results at correcting PIP joint contractures, both early and late.
Partial Fasciectomy for Dupuytren’s
Dupuytren’s patients need two things: first, a way to prevent disease progression and recurrence; second, the simplest, safest way to straighten fingers bent by Dupuytren’s. While working and waiting on the first, there are choices for the second. One of these is limited or partial fasciectomy, which has the advantage
TGF-ß2 and Dupuytren’s
What if Dupuytren’s is due to slightly abnormal levels of a normal hormone, protein or other molecule in the system? If so, one of the most likely suspects would be Transforming Growth Factor Beta Two: TGF-ß2. This protein is part of the autocrine system (a chemical instant messaging system which
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
