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Medline Title Search (Dupuytren + (“Extension Torque” or “Skeletal Traction” or “Distraction”)

Skeletal traction can be a useful adjunct for Dupuytren contracture with PIP capsuloligamentous soft tissue changes. Traction alone has been reported to be followed by rapid recontracture (Citron 1998). Fasciectomy followed by traction has been reported to have a high complication rate including RSD/SMP/CRPS and stiffness (Beard 1996, Citron 1998). Traction followed by fasciectomy has the best overall reported results: in 86 patients with composite contractures greater than 135° four year follow up showed 10% recurrence, 0% RSD, 85% good to excellent results, 16% stiffness (Messina 2017).

Selected Publications

  • Agee JM, Goss BC. The use of skeletal extension torque in reversing Dupuytren contractures of the proximal interphalangeal joint. J Hand Surg Am. 2012;37(7):1467–74. (PDF)
  • Azouz S, Biswas A, Smith A. Preliminary Soft-Tissue Distraction with the Digit Widget in the Management of Advanced Dupuytren Contracture at the Proximal Interphalangeal Joint. In: Eaton C, Seegenschmiedt MH, Bayat A, Gabbiani G, Werker P, Wach W, eds. Dupuytren Disease and Related Diseases – The Cutting Edge. Switzerland: Springer International Publishing; 2017:285-290. (PDF)
  • Bailey AJ, Tarlton JF, Van der Stappen J, Sims TJ, Messina A. The continuous elongation technique for severe Dupuytren’s disease. A biochemical mechanism. J Hand Surg Am. 1994;19 B(4):522-527. doi:10.1016/0266-7681(94)90220-8 (PDF)
  • Beard AJ, Trail IA. The “S” Quattro in severe Dupuytren’s contracture. J Hand Surg Br. 1996;21(6):795-796. (PDF)
  • Brandes G, Messina A, Reale E. The palmar fascia after treatment by the continuous extension technique for Dupuytren’s contracture. J Hand Surg Br. 1994;19(4):528-533. (PDF)
  • Brandes G, Reale E, Messina A. Microfilament system in the microvascular endothelium of the palmar fascia affected by mechanical stress applied from outside. Virchows Arch. 1996;429(2-3):165-172. (PDF)
  • Citron N, Messina JC. The use of skeletal traction in the treatment of severe primary Dupuytren’s disease. J Bone Joint Surg Br. 1998;80(1):126–9. (PDF)
  • Corain M, Zanotti F, Sartore R, Pozza P. Proposal for Treatment of Severe Dupuytren Disease in 2 Steps: Progressive Distraction With External Fixator and Collagenase – A Preliminary Case Series. Hand. 2019:155894471882208. doi:10.1177/1558944718822086 (PDF)
  • Craft RO, Smith AA, Coakley BB, Casey 3rd WJ, Rebecca AM, Duncan SFM, et al. Preliminary soft-tissue distraction versus checkrein ligament release after fasciectomy in the treatment of dupuytren proximal interphalangeal joint contractures. Plast Reconstr Surg . 2011; 128 ( 5 ):113–1107. (PDF)
  • Hodgkinson PD. The use of skeletal traction to correct the flexed PIP joint in Dupuytren’s disease. A pilot study to assess the use of the Pipster. J Hand Surg Br. 1994;19(4):534–7. (PDF)
  • Houshian S, Chikkamuniyappa C. Distraction correction of chronic flexion contractures of PIP joint: comparison between two distraction rates. J Hand Surg Am. 2007;32(5):651-656. doi:10.1016/j.jhsa.2007.02.015 (PDF)
  • Houshian S, Jing SS, Kazemian GH, Emami-Moghaddam-Tehrani M. Distraction for Proximal Interphalangeal Joint Contractures: Long-Term Results. J Hand Surg Am. 2013;38(10):1951-1956. (PDF)
  • Kasabian A, McCarthy J, Karp N. Use of a multiplanar distracter for the correction of a proximal interphalangeal joint contracture. Ann Plast Surg. 1998;40(4):378-381. (PDF)
  • Kawakatsu M, Saito S. Simultaneous Regional Fasciectomy, Skin Grafting, and Distraction Arthrolysis of the Proximal Interphalangeal Joint for Dupuytren’s Contracture of the Little Finger. Hand Surg. 2015;20(02):298–301. (PDF)
  • Lawson GA, Smith AA. Dynamic External Fixation in the Treatment of Dupuytren’s Contracture. In: Eaton C, Seegenschmiedt MH, Bayat A, Gabbiani G, Werker P, Wach W, eds. Dupuytren’s Disease and Related Hyperproliferative Disorders. Berlin Heidelberg: Springer-Verlag; 2012:297-303. (PDF)
  • Loos B, Horch RE. Skeletal traction treatment of severe finger contracture: a new innovative skeletal distraction device. Plast Reconstr Surg. 2008;122(2):99e – 100e. (PDF)
  • Messina A, Messina J. The TEC treatment (continuous extension technique) for severe Dupuytren’s contracture of the fingers. Ann Chir la Main. 1991;10(3):247-250. doi:10.1016/S0753-9053(05)80290-X (PDF)
  • Messina A, Messina J. The continuous elongation treatment by the TEC device for severe Dupuytren’s contracture of the fingers. Plast Reconstr Surg. 1993;92(1):84-90. (PDF)
  • Messina A. The Continuous Elongation Technique in Dupuytren’s Disease. In: Berger A, Delbruck A, Brenner P, Hinzmann B, eds. Dupuytren’s Disease Pathobiochemistry and Clinical Management. Berlin: Springer-Verlag; 1994:291-296. (PDF)
  • Messina JC, Messina A. Indications of the Continuous Extension Technique (TEC) for Severe Dupuytren Disease and. In: Eaton C, Seegenschmiedt MH, Bayat A, Gabbiani G, Werker P, Wach W, eds. Dupuytren Disease and Related Diseases – The Cutting Edge. Switzerland: Springer International Publishing; 2017:311-316. (PDF)
  • Rajesh KR, Rex C, Mehdi H, Martin C, Fahmy NR. Severe Dupuytren’s contracture of the proximal interphalangeal joint: treatment by two-stage technique. J Hand Surg Br. 2000;25(5):442-444. (PDF)
  • White JW, Kang S-N, Nancoo T, Floyd D, Kambhampati SBS, McGrouther D a. Management of severe Dupuytren’s contracture of the proximal interphalangeal joint with use of a central slip facilitation device. J Hand Surg Eur Vol. 2012;37(8):728-732. (PDF)