Blog
Sorting out the truth
Don’t believe everything you read about Dupuytren’s – even in respectable journals. I was aware that reflex sympathetic dystrophy (complex regional pain syndrome) was more common after fasciectomy for Dupuytren’s than for other hand operations, but there is little published on this. Then, this report came out documenting surprisingly high
Lessons from Peyronie’s for Dupuytren’s
Peyronie’s disease is more common than Dupuytren’s – 3 to 9 percent of the population – and shares a similar biology and genetic predisposition. Progress in the treatment of Peyronie’s will benefit that of Dupuytren’s and vice versa. Taken in this context, these two articles by Hellstrom from 2000 and
Looking at Dupuytren’s with MRI
Where is Dupuytren’s? It’s been known for some time that Dupuytren’s involvement can be identified by MRI, as described in these articles:https://www.dupuytrens.org/DupPDFs/1993_Yacoe_813.pdfhttps://www.dupuytrens.org/DupPDFs/1994_Miller.pdfand it’s likely that the activity of the process could be mapped, both for predictive value and for targeted treatment to prevent progression. Now, these papers are 15 years
The Fish Technique for Dupuytren’s: Fasciectomy and Skin Graft
Skin grafts are used in a variety of approaches for Dupuytren’s: to add skin where it has been shortened (fasciotomy and skin graft, fasciectomy and skin graft); to replace skin where it has been removed to prevent recurrence (dermofasciectomy and skin graft). This study reviews the results of fasciectomy and
Accidental fasciotomy for Dupuytren’s
Fingers bent by Dupuytren’s can complicate a fall on an outstretched hand: because the fingers can’t stretch back, the force of impact is redistributed, making it more likely to break hand bones. When the fall is hard enough to break something, occasionally what gives is not bone, but the Dupuytren
No advantage to open Proximal Interphalangeal Joint release for Dupuytren’s
Proximal interphalangeal joint contractures from Dupuytren’s disease take on a life of their own, persisting after the Dupuytren’s has been removed. One of the arguments for open fasciectomy is that PIP contractures can be treated by openly releasing the tight joint capsule and ligaments. Unfortunately, gains made in the operating
Dupuytren’s and Burns
Dupuytren’s overlaps in some ways with the local excessive scarring which occur after a burn injury. This report documents the development of progressive Dupuytren’s disease developing in a young man after a hand burn, and reviews the conventional teachings regarding Dupuytren’s: https://www.dupuytrens.org/DupPDFs/2008_Balakrishnan_1422.pdf
Gene Expression in Dupuytren’s
If Dupuytren’s is inherited, what are the genes involved? Difficult question. Every cell in a person’s body has the same genes, but every cell is not the same. The differences between cells are not from different genes, but from differences in gene expression: every cell in the body is like
ß-catenin, Wnt and Dupuytren’s
Ultimately, Dupuytren’s has to do with cell signalling: normal cells are somehow instructed (“signalled”) to become abnormal, and adjacent cells interact with each other in a progression of abnormal changes. One of the many ways that cell signal each other is the Wnt signaling pathway, which involves a series of
Recent Dupuytren Publications
- Mortality in patients with Dupuytren's disease in the first 5 years after diagnosis: a population-based survival analysis
- The impact of rising NHS waiting list times on elective surgery for Dupuytren's disease
- Comparing Complications and Patient Satisfaction Following Injectable Collagenase Versus Limited Fasciectomy for Dupuytren's Disease: A Systematic Review and Meta-Analysis
- Pain-Relieving Effects of Shockwave Therapy for Ledderhose Disease: An Ultrasound-Based Study of an Unusual Bilateral Case
- Surgery, Needle Fasciotomy, or Collagenase Injection for Dupuytren Contracture : A Randomized Controlled Trial