Blog
Open fasciotomy for Dupuytren’s
Patients with Dupuytren’s need two things, mechanical and biological. The former, a simple and safe way to straighten bent fingers, and the latter, a way to prevent disease progression and recurrence. This article reviews pros and cons of a simple mechanical treatment, open fasciotomy, for severe contractures in a group
Genetic determined biochemistry and Dupuyren’s
The genetic basis of Dupuytren’s is explained by the genetic basis of individual biochemistry and enzymatic variation. Sort of. This fascinating review shows how complicated this can be: http://www.dupuytrenfoundation.org/DupPDFs/2008_Zyluk.pdf
Verapamil, tamoxifen, carnitine – options?
One resource for potential medical treatment of Dupuytren’s is the literature on medicines which work for related conditions such as Peyronie’s. This review examines the rationale and results of propionyl-L-carnitine, acetyl-L-carnitine, verapamil and tamoxifen in treating Peyronie’s disease. Is there a role for these in Dupuytren’s? http://www.dupuytrenfoundation.org/DupPDFs/2002_Cavallini.pdf
Dupuytren’s and Frozen shoulder
About one in six patients with frozen shoulder will also have Dupuytren’s disease and vice versa. Frozen shoulder has been called “Dupuytren’s of the shoulder”: the abnormal tissues are quite similar. However, they are different in other respects – for example, Dupuytren’s commonly recurs after surgical treatment, but frozen shoulder
Vascular cause of Dupuytren’s?
Diabetes, hypertension, stiff finger joints and Dupuytren’s: This study uses retinopathy as an index of vascular disease and suggests that small vessel disease, rather than the effect of blood sugar on collagen, is the link between diabetes and Dupuytren’s: http://www.dupuytrenfoundation.org/DupPDFs/1986_Larkin_1218.pdf
Peyronie’s Disease and Dupuytren’s
Dupuytren’s is one manifestation of a systemic fibrotic disorder that can also show up as Ledderhose, frozen shoulder or Peyronie’s disease. Fortunately, the majority of people affected show only one of these conditions, but many have to deal with several or all of these. This summary reviews the condition referred
A landmark advance in understanding Dupuytren’s
Two methods of investigating Dupuytren’s have been used: Demographic – family studies, associations with medications, activities, other diseases; and Biological – tissue analysis. The big biologic breakthrough came in 1972 when Gabbiani and others published two articles back to back findings on the biology of myofibroblasts:http://www.dupuytrenfoundation.org/DupPDFs/1972_Gabbiani_719.pdfand the role of myofibroblasts
Smooth Muscle Actin in Dupuytren’s Contracture
The palmar fascia in Duputren’s contracture does not contract like a muscle: it’s more like the effect of an army of tiny rachets. Adjacent parallel strands of collagen are grabbed by myofibroblasts, which then shorten (“crimp”) lengthwise, pulling the strands to overlap more and more, and then gluing these strands
CMMS therapy for stiffness after fasciectomy for Dupuytren’s
Stiffness is a common problem after fasciectomy, particularly loss of flexion, and can be resistant to stretching exercises or splints. This therapy program, incorporating a combination of casting and active exercises, helped patients regain motion when they had failed conventional hand therapy: http://www.dupuytrenfoundation.org/DupPDFs/2007_Rose.pdf
Recent Dupuytren Publications
- Patient Experiences With Hand Surgery in the Office Versus Ambulatory Surgery Center
- Collagenase Treatment Versus Needle Fasciotomy for Single-Digit Dupuytren Contractures: A Meta-Analysis of Randomized Controlled Trials
- Exploring the potential relationship between frozen shoulder and Dupuytren's disease through bioinformatics analysis and machine learning
- Objective and subjective assessment of Dupuytren's contracture
- Can You Go the Distance: Collagenase <em>Clostridium histolyticum</em> Manipulation at 1 Month after Injection
