Functional Benefit of Dupuytren’s Surgery

2002 ◽  
Vol 27 (4) ◽  
pp. 378-381 ◽  
Author(s):  
R. SINHA ◽  
T. R. CRESSWELL ◽  
R. MASON ◽  
I. CHAKRABARTI
Keyword(s):  
Hand Function ◽  
Dupuytren’S Disease ◽  
Flexion Deformity ◽  
Dupuytren's Disease ◽  
Functional Benefit ◽  
Operative Result ◽  
The Mean ◽  
Results Of Surgery

The results of surgery for Dupuytren’s disease were prospectively assessed to see if there is a correlation between hand function, the degree of deformity and the post-operative result. A total of 42 patients were followed-up for 6 months. The mean flexion deformity was 81° pre-operatively and 32° post-operatively. The mean Sollerman score improved from 71 (out of 80) pre-operatively to 77 post-operatively. There was a significant correlation between the degree of deformity and the Sollerman score, and also between the improvement in deformity after surgery, and the Sollerman score. We conclude that hand function is worsened by increasing deformity in Dupuytren’s disease and improved by correction of the deformity.

THE McCASH TECHNIQUE FOR DUPUYTREN'S DISEASE: OUR EXPERIENCE

Hand Surgery ◽  
2014 ◽  
Vol 19 (01) ◽  
pp. 61-67 ◽  
Author(s):  
Aristides B. Zoubos ◽  
Nikolaos A. Stavropoulos ◽  
George C. Babis ◽  
Andreas F. Mavrogenis ◽  
Zinon T. Kokkalis ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Sensory Evaluation ◽  
Rehabilitation Program ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Bilateral Involvement ◽  
Pip Joint ◽  
The Mean ◽  
Acceptable Outcome

This study presents the clinical outcomes of 35 hands with Dupuytren's Disease treated with the McCash technique between 1990 and 2009. Of the 31 patients (28 males and three females, mean age 53 yrs), four patients had bilateral involvement (12.9%). Thirty hands had no previous medical or surgical treatment for the disease, while the remaining five hands had been operated on at least once. The mean contracture of metacarpophalangeal (MCP) joint improved from 42.14° to 1.83°, while that of the proximal interphalangeal (PIP) joint improved from 62.60° to 7.09°. All wounds healed within a mean 9.8 weeks. Sensory evaluation revealed no permanent numbness. With realistic expectations, clear documentation, meticulous surgical technique and implementation of a demanding post-operative rehabilitation program, an acceptable outcome may be achieved with the McCash technique for Dupuytren's disease.

scholarly journals Recent advances in the understanding of Dupuytren’s disease

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 231 ◽  
Author(s):  
Thomas Layton ◽  
Jagdeep Nanchahal
Keyword(s):  
Hand Function ◽  
Therapeutic Targets ◽  
Therapeutic Options ◽  
Dupuytren’S Disease ◽  
Treatment Modalities ◽  
Dupuytren's Disease ◽  
Recent Advances ◽  
Cellular Factors ◽  
Fibrotic Disorder ◽  
Novel Therapeutic

Dupuytren’s disease (DD) is a common fibrotic disorder of the hand and can significantly impair hand function. Although the exact pathogenesis of this disorder remains to be elucidated, immunological, genetic and cellular factors likely interact. In this review, we summarise recent advances in the understanding of DD pathogenesis and look to the future for potential novel therapeutic targets. In addition, we discuss the therapeutic options in DD with a focus on the need for more rigorous evidence to allow a meaningful comparison of different treatment modalities.

Dupuytren's Contracture. The Safety and Efficacy of Collagenase Treatment

2016 ◽  
Vol 21 (02) ◽  
pp. 187-192 ◽  
Author(s):  
Adalsteinn Odinsson ◽  
Lars Erik Brenne ◽  
Tone Bøyesen Lurie ◽  
Vilhjalmur Finsen
Keyword(s):  
Patient Satisfaction ◽  
Hand Function ◽  
Primary Treatment ◽  
Dupuytren’S Disease ◽  
Successful Outcome ◽  
Extension Deficit ◽  
Serious Adverse Events ◽  
Dupuytren's Disease ◽  
Collagenase Injection ◽  
New Treatment

Background: Our main goal was to see if treatment with collagenase injection is safe and effective and to assess patient satisfaction with this new treatment. Methods: We prospectively followed 77 consecutive patients, treated for contracture in 91 fingers and 142 joints that received total of 109 collagenase injections. The patients were reviewed on the first and second day and at 4 and 12 months. A contracture reduced to five degrees or less at 12 months after the last injection, was considered to be a successful outcome. Results: A mean of 1.2 injections were used per patient and 0.8 injections per joint. There was a significant improvement in mean passive extension deficit. Out of the 142 joints treated, 84 (59%) met our criterion for a successful outcome; 56 (80%) out of 70 MCP joints and 28 (39%) out of 72 PIP joints. There were also significant improvements in both hand function and pain. No serious adverse events were observed. The mean patient satisfaction with the treatment at the 12-month follow up was a VAS score of 78 (0 = none; 100 = complete) and only 11% stated that they would not have consented to the treatment if they had known the outcome in advance. Conclusions: Treatment of Dupuytren's disease with collagenase injection is both safe and effective. It is now our primary treatment for Dupuytren's disease.

scholarly journals Hand function 5 years after treatment with collagenase Clostridium histolyticum injection for Dupuytren’s disease

2021 ◽  
pp. 175319342110023
Author(s):  
Ingrid Göransson ◽  
Lars Brudin ◽  
Andra Irbe ◽  
Christina Turesson
Keyword(s):  
Range Of Motion ◽  
Hand Function ◽  
Treatment Method ◽  
Dupuytren’S Disease ◽  
Collagenase Clostridium Histolyticum ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Dupuytren's Disease ◽  
Clostridium Histolyticum ◽  
New Treatment

The aim of this study was to report hand function, disability and satisfaction and patients’ perception of functionally troublesome contractures 5 years after injection with collagenase Clostridium histolyticum and hand therapy for Dupuytren's disease. Data from 79 patients were collected before and at 3, 12 and 60 months after treatment. Hand function was significantly improved, and 70% achieved a functional range of motion in the treated hand. QuickDASH scores and range of motion were best at 3 months follow-up. At 60 months, mean total extension deficit was 48°, which was 57% of the deficit before treatment. Thirty-seven patients (47%) had developed recurrent contractures in treated finger(s) meeting the criteria for new treatment. The threshold for functionally troublesome contractures was found to be 30°–60° in the finger joints. Treatment was experienced as painful, but few hand function problems occurred. Most patients would choose this treatment method again. Level of evidence: IV

Contracture of the Proximal Interphalangeal Joint in Dupuytren’s Disease

1991 ◽  
Vol 16 (4) ◽  
pp. 446-448 ◽  
Author(s):  
J. G. ANDREW
Keyword(s):  
Anatomical Study ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Corrective Surgery ◽  
Collateral Ligaments ◽  
Flexion Deformity ◽  
Dupuytren's Disease ◽  
Secondary Damage ◽  
Fixed Flexion Deformity

The correction of fixed flexion deformity at the P.I.P. joint in Dupuytren’s disease is often difficult. This paper reports an anatomical study of this joint in fingers amputated because of this condition. All the joints would extend fully after release of the accessory collateral ligaments and volar plate. Lateral and dorsal structures showed severe secondary damage and it is suggested that these changes may explain the poor results of corrective surgery to this joint in Dupuytren’s disease.

scholarly journals Measurement properties of the Dutch Unité Rhumatologique des Affections de la Main and its ability to measure change due to Dupuytren’s disease progression compared with the Michigan Hand outcomes Questionnaire

2018 ◽  
Vol 43 (8) ◽  
pp. 855-863 ◽  
Author(s):  
Dieuwke C. Broekstra ◽  
Edwin R. van den Heuvel ◽  
Rosanne Lanting ◽  
Paul M. N. Werker
Keyword(s):  
Disease Progression ◽  
Hand Function ◽  
Dupuytren’S Disease ◽  
Receiver Operating Curve ◽  
Measurement Properties ◽  
Minimal Important Change ◽  
Level Of Evidence ◽  
Dupuytren's Disease ◽  
Smallest Detectable Change ◽  
Prospective Longitudinal

Data of a prospective longitudinal cohort study including 233 Dupuytren’s patients was used to determine: (1) whether the Unité Rhumatologique des Affections de la Main scale and Michigan Hand outcomes Questionnaire can detect change in hand function due to Dupuytren’s disease progression and to compare their abilities; (2) the concurrent validity, reliability, responsiveness and interpretability of the Dutch Unité Rhumatologique des Affections de la Main. The Unité Rhumatologique des Affections de la Main and Michigan Hand outcomes Questionnaire had comparable measurement properties, and were both able to distinguish participants with disease progression from those without progression (resp. U = 1252.5, p = 0.008, and U = 1086.0, p < 0.001), but only at a group level. Individual cases of progression could not be detected using these outcome measures, as indicated by the fact that the smallest detectable change was larger than the minimal important change, and area under the receiver operating curve (AUC) values of 0.75 for Michigan Hand outcomes Questionnaire and 0.67 for Unité Rhumatologique des Affections de la Main. Level of evidence: II

A Comparison of Methods of Treatment of Pip Joint Contractures in Dupuytren’s Disease

1996 ◽  
Vol 21 (2) ◽  
pp. 246-251 ◽  
Author(s):  
C. M. BREED ◽  
P. J. SMITH
Keyword(s):  
Surgical Intervention ◽  
Dupuytren’S Disease ◽  
Comparison Of Methods ◽  
Flexion Deformity ◽  
Dupuytren's Disease ◽  
Joint Contractures ◽  
Joint Level ◽  
Pip Joint ◽  
Methods Of Treatment

An analysis of the different methods of treating residual flexion deformity at the PIP joint level after digital fasciectomy in 75 PIP joints has shown that gentle passive manipulation alone gives better results with fewer complications than more aggressive surgical intervention.

scholarly journals Management of Dupuytren's Disease – Clear Advice for an Elusive Condition

2006 ◽  
Vol 88 (1) ◽  
pp. 3-8 ◽  
Author(s):  
A Bayat ◽  
DA McGrouther
Keyword(s):  
Age Of Onset ◽  
Positive Family History ◽  
Significant Risk ◽  
Unknown Origin ◽  
Postoperative Recovery ◽  
Flexion Contracture ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Functional Benefit ◽  
Soles Of The Feet

Dupuytren's disease is a progressive fibroproliferative disorder of an unknown origin affecting the hands causing permanent flexion contracture of the digits. Significant risk factors for development of Dupuytren's disease include old age, male sex, white northern European extraction, presence of positive family history of Dupuytren's disease, and diabetes mellitus. The disease also seems to deteriorate rapidly in those cases showing young age of onset and additional fibromatosis affecting the back of the hands, soles of the feet and the penis. Although there is no cure, patients with Dupuytren's disease of the hand may gain a significant functional benefit following surgical improvement or correction of the deformity. With realistic expectations, timely and appropriate surgical technique in a specialist centre, and attention to postoperative recovery and rehabilitation (occupational therapy and physiotherapy support), a beneficial outcome can be achieved in most cases.

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