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Akinori Sakai, Yukichi Zenke, Kunitaka Menuki, Yoshiaki Yamanaka, Takafumi Tajima, Soshi Uchida
BACKGROUND: Some cases treated with open palm technique need relatively long wound healing time. This study aims to clarify whether the preoperative lifestyle-related diseases or factors are associated with surgical results after the open palm technique for Dupuytren's contracture. METHODS: The study included 122 fingers of 84 hands of 84 consecutive male patients with Dupuytren's contracture who were treated with McCash's open palm technique at our hospital from 1980 to 2016...
March 2019: Journal of Hand Surgery Asian-Pacific Volume
Jenny Reid, Jill Baker, Dominique Davidson
We present the case of a fit and well 62-year-old male with Dupuytren's disease in the right hand who underwent percutaneous needle fasciotomy (PNF) for a moderate flexion contracture of the right little finger. 18 months later he developed a pain-free soft tissue swelling at the distal previous needling site. A fasciectomy procedure identified a cyst within the pre-tendinous cord, which was confirmed as a dermoid inclusion cyst on histological analysis. Dermoid inclusion cysts may occur in the hands at the site of penetrating trauma but we are unaware of any report of an inclusion cyst at the site of PNF surgery...
March 2019: Journal of Hand Surgery Asian-Pacific Volume
Charlotte Hartig-Andreasen, Lena Schroll, Jeppe Lange
INTRODUCTION: The optimal minimal invasive treatment for Dupuytren's contractures (DC) remains debated. The aim of this study was to evaluate the effect of Clostridium histo-lyticum collagenase after 1-4 years of follow-up. The out-comes of this study were 1) overall improvements in degrees from baseline to follow-up; 2) contraction recurrence defined as an extension deficit above 20°, and 3) Hurst endpoint defined as an extension deficit below 5°. METHODS: All patients treated with C...
February 2019: Danish Medical Journal
Mélissa Roy, Karen Okrainec, Christine B Novak, Herbert P von Schroeder, David R Urbach, Steven J McCabe
BACKGROUND: Health literacy represents the degree to which patients can understand and act on health information. The relevance of health literacy to health care delivery, outcomes, and overall surgical care is unambiguous. This study aimed (1) to determine the prevalence of limited health literacy in patients diagnosed with Dupuytren's contracture and (2) to identify independent predictors of limited health literacy. METHODS: This cross-sectional study included patients with Dupuytren's disease and with self-reported English fluency...
February 2019: Plastic and Reconstructive Surgery
Sophie A Riesmeijer, Oliver W G Manley, Michael Ng, Ilja M Nolte, Dieuwke C Broekstra, Paul M N Werker, Dominic Furniss
BACKGROUND: Dupuytren's disease is a very common, highly heritable palmar fibromatosis. In a recent genome-wide association study, 26 single-nucleotide polymorphisms were found to be associated with development of Dupuytren's disease. The authors generated a weighted genetic risk score based on the genotype at these single-nucleotide polymorphisms. In two independent cohorts, they tested the association among high weighted genetic risk score, clinical features that predict a high risk of recurrence, and recurrence after surgery...
February 2019: Plastic and Reconstructive Surgery
John Z Zhao, Philip E Blazar, Ariana N Mora, Brandon E Earp
PURPOSE: Range of motion (ROM) measurements of the fingers are frequently obtained during hand physical examinations. While traditionally measured by manual goniometry, smartphone photography introduces an alternative method of ROM measurement that also has potential telemedicine applications. The purpose of this study was to evaluate the reliability of smartphone photography measurements as an alternative to traditional goniometry, using the patient with Dupuytren disease as a model...
January 28, 2019: Hand: Official Journal of the American Association for Hand Surgery
Jason Fletcher, Ezekiel S L Tan, Michael Thomas, Fraser Taylor, Devlin Elliott, Randy Bindra
BACKGROUND: Dupuytren's disease causes a flexion contracture of the hand that limits hand function and reduces quality of life. Traditional management is surgical excision which is associated with potentially serious complications. A viable alternative is collagenase Clostridium histolyticum (CCH) (Xiaflex®; Pfizer Australia) which is an effective, safe, outpatient treatment that to date has no published data in the Australian public health setting. METHODS: A prospective cohort, single centre study, enrolling 54 patients to treat 81 joints with CCH...
January 26, 2019: ANZ Journal of Surgery
Jonathan Cook, Jessica Waughtel, Anthony R Andreoni, Aniket Sakharpe, David Friedman
BACKGROUND: The U.S. FDA approved collagenase Clostridium histolyticum (CCH) for treatment of Dupuytren contracture in 2010, and approved CCH for the concurrent treatment of up to two cords in 2014. Although outcomes and adverse events (AEs) have been well described for single injections, comparative data on concurrent injections is lacking. METHODS: We reviewed 121 concurrent CCH injections and compared these with 177 single CCH injections over eight years. All injections were performed by a single surgeon, our senior author...
January 21, 2019: Plastic and Reconstructive Surgery
Anne-Gita Scheibler, Miriam Marks, Stefanie Hensler, Daniel B Herren, Maurizio Calcagni
INTRODUCTION: Several studies have investigated the clinical outcome after collagenase treatment for Dupuytren's disease in terms of range of motion of the affected finger. However, good objective clinical outcome defined by a small remaining flexion contracture does not necessarily translate into satisfactory patient-subjective hand function. The aim of the present study was to identify predictors of patient-reported as well as objective clinical outcome in patients 1 year after collagenase treatment for Dupuytren's disease...
January 23, 2019: Archives of Orthopaedic and Trauma Surgery
G Raimbeau, N Bigorre, W Balti, F Rabarin, J Jeudy, P-A Fouque, B Cesari, Y Saint-Cast
Severe contracture of the little finger due to Dupuytren's disease continues to be a therapeutic problem. Fifth finger amputation, which is sometimes the only solution, has a major negative impact on function and appearance, and exposes the patient to adjacent digital hook aggravation. Middle phalangectomy with finger shortening fusion is an alternative surgical solution. The aim of this study was to report on a continuous series of 36 cases treated with this approach. This was a retrospective series of 33 patients (26 males and 7 females) operated from 1994 to 2015...
January 18, 2019: Hand Surgery and Rehabilitation
Julia Krassovka, Annika Borgschulze, Benita Sahlender, Tim Lögters, Joachim Windolf, Vera Grotheer
Dupuytren's contracture is a fibroproliferative disorder affecting the palmar fascia of the hand. Most affected are the ring fingers, and little fingers of middle-aged men. Symptomatic for this disease is the increased proliferation and differentiation of fibroblasts to myofibroblasts, which is accompanied by an elevated α-SMA expression. The present study evaluated the therapeutic benefit of blue light (λ = 453 nm, 38 mW/cm2, continuous radiance, spot size 10-12 cm2) as well as the molecular mechanism mediating this effect...
2019: PloS One
Casey M Beleckas, William Gerull, Melissa Wright, Jason Guattery, Ryan P Calfee
PURPOSE: This study aimed to determine whether Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function and Pain Interference scores varied at presentation for specialty care by nontrauma hand condition. The secondary aim was to compare PROMIS scores with a reference standard, the Quick-Disabilities of the Arm, Shoulder, and Hand (QuickDASH), regarding the magnitude and direction of score differentials among diagnoses. METHODS: PROMIS Physical Function and Pain Interference scores were analyzed from 1,471 consecutive new adult patient clinic visits at a tertiary orthopedic hand clinic presenting with 1 of 5 nontrauma hand conditions...
December 18, 2018: Journal of Hand Surgery
Paul Stirling, Paul J Jenkins, Nicholas D Clement, Andrew D Duckworth, Jane E McEachan
The Friends and Family Test, a variant of the Net Promoter Score, was adapted for the National Health Service to evaluate overall patient satisfaction and how likely patients are to recommend an intervention. It ranges from -100 to 100. Positive scores indicate good performance. This study quantifies the scores in 810 patients at a mean of 14 months following four common procedures. The score was 83 for trigger finger release ( n = 103), 68 for carpal tunnel decompression ( n = 467), 62 for surgery for Dupuytren's disease ( n = 224) and 44 for ganglia excision ( n = 16)...
December 19, 2018: Journal of Hand Surgery, European Volume
Tiberiu Paul Neagu, Mirela Ţigliş, Andreea Popescu, Valentin Enache, Şerban Arghir Popescu, Ioan Lascăr
Ledderhose disease or plantar fibromatosis is a rare hyperproliferative disorder of the plantar aponeurosis, clinically characterized by nodules situated especially on the medial border of the foot. It is histopathologically associated with Dupuytren's disease. This disease has some risk factors, like old age, alcohol or nicotine abuse, liver dysfunction, trauma or exposure to vibrations and autoimmune disorders, but the exact etiology is still unknown. Even though it is benign, the local manifestations can be aggressive, leading to debilitating deformities and contractures of the toes...
2018: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Mary Kate Thayer, Jeremy S Somerson, Jerry I Huang
Background: Collagenase Clostridium histolyticum (CCH) injection has been shown to be a safe and effective treatment option for Dupuytren's contracture. We hypothesize that the gaining popularity of CCH has resulted in a change in treatment patterns among providers, with increased utilization of CCH injections in the management of Dupuytren's contracture from 2012 to 2014. Methods: The Medicare Provider Utilization and Payment Data Public Use Files were used to identify all surgeons who submitted claims for surgical fasciectomy, needle aponeurotomy (NA), and CCH injection...
October 2018: Plastic and Reconstructive Surgery. Global Open
Ruud W Selles, Chao Zhou, Hester J Kan, Robbert M Wouters, Christianne A van Nieuwenhoven, Steven E R Hovius
BACKGROUND: In the Dupuytren Rotterdam randomized controlled trial, percutaneous aponeurotomy with lipofilling (PALF) was as effective as limited fasciectomy in correcting primary Dupuytren's contracture after 1 year. The authors report the 5-year results of this trial, with a special focus on recurrence of contractures. METHODS: The authors invited all patients who had undergone PALF or limited fasciectomy to participate in a posttrial follow-up assessment. Thirty-one PALF patients and 21 limited fasciectomy patients were assessed by an independent examiner for the degree of contracture and whether patients had undergone a secondary procedure...
December 2018: Plastic and Reconstructive Surgery
Benjamin H Miranda, Charlotte Elliott, Christopher C Kearsey, David N Haughton, Mark R Webb, Ian Harvey, Fahmy S Fahmy
BACKGROUND: Numerous Dupuytren's fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren's disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren's disease and unite current limited fasciectomy practice that varies considerably between surgeons. METHODS: We describe the 3DF principles; raising thin skin flaps (addressing dermal involvement), excising diseased palmar fascia with a 3-5 mm clearance margin (treating highly locally recurrent conditions) and excising the vertical septae of Legueu and Juvara (providing deep clearance, hence addressing all potentially involved pathological tissue)...
November 2018: Archives of Plastic Surgery
Grazia Aleppo, Lauren G Kanapka, Nicole C Foster, Mengdi Wu, Mark A Clements, Michael R Rickels, Janet B McGill, Roy W Beck
BACKGROUND: Diabetic cheiroarthropathy is a long-term complication of diabetes that causes significant morbidity and can impair functional abilities. It has not been well studied in individuals with type 1 diabetes (T1D). The T1D Exchange registry provided an opportunity to assess the frequency of cheiroarthropathy and related characteristics. MATERIALS AND METHODS: An internet-based survey was sent to 6,199 registry participants >18 years old, with 1,911 (31%) responding (62% female, 90% non-Hispanic White, mean age 40 yrs, median diabetes duration 20 yrs, mean HbA1c 7...
November 1, 2018: Endocrine Practice
Jesper Nordenskjöld, Stina Brodén, Isam Atroshi
BACKGROUND: The most commonly reported outcome measure in Dupuytren disease is the extension deficit in finger joints. This study aimed to investigate the examiners' influence on the measured difference between active and passive extension deficit. METHODS: A prospective cohort study was conducted on 157 consecutive patients (81% men, mean age 70 years) scheduled for collagenase treatment for Dupuytren disease. Before injection, one of three experienced hand therapists measured active extension deficit (AED) and passive extension deficit (PED) in the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the affected fingers using a hand-held metal goniometer...
October 29, 2018: BMC Medical Research Methodology
Ahmad J Abdulsalam, Dia Shehab, Adlia Abd Elhady, Mini Abraham
BACKGROUND: Dupuytren's disease of the hand is characterized by progressive thickening and shortening of palmar fascia resulting in flexion deformities of the digits and hence limitation of hand function. The objective of this study was to evaluate the effectiveness of shock-wave therapy on patients with Dupuytren's disease of the hand. CASE SERIES: A case series study observed a total of four patients with Dupuytren's disease of the hand. All four patients had diabetes...
October 29, 2018: European Journal of Physical and Rehabilitation Medicine
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