Analysis of recurrence and complications after percutaneous needle fasciotomy in Dupuytren’s disease

Moog, Philipp; Buchner, Lara; Černý, M; Schmauß, Daniel; Megerle, Kai; Erne, H.

doi:10.1007/s00402-019-03247-y

Cited by 11 publications

(10 citation statements)

References 31 publications

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“…Following the “damage” of needling, the fascia will regenerate via myo/fibroblasts matching the bio-mechanical state. Evidence suggests that fascia regenerates within approximately 3–24 months after fasciectomy/fasciotomy [ 106 , 107 ]. It is unlikely that tearing the fascia (if done properly) will seriously compromise physiology as this would have manifested as a complication after every invasive surgical operation.…”

Section: Discussionmentioning

confidence: 99%

Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle

Plaut

2022

PLoS ONE

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Background Myofascial Pain Syndrome (MPS) is a common, overlooked, and underdiagnosed condition and has significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease. Methods Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews. Findings 799 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence. Conclusions MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue (“fascial armoring”). Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. A “global percutaneous needle fasciotomy” that respects tensegrity principles may treat MPS/fibromyalgia more effectively. “Functional-somatic syndromes” can be seen as one entity (myofibroblast-generated-tensegrity-tension), sharing a common rheuma-psycho-neurological mechanism.

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Section: Discussionmentioning

confidence: 99%

Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle

Plaut

2022

PLoS ONE

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“…Evidence suggests that fascia regenerates within approximately 3-24 months after fasciectomy/fasciotomy. 106,107 It is unlikely that tearing the fascia (if done properly) will seriously compromise physiology as this would have manifested as a complication after every invasive surgical operation. New extracellular fiber deposition will be based on optimized structural conformation.…”

Section: Discussionmentioning

confidence: 99%

Scoping review and interpretation of Myofascial Pain/Fibromyalgia syndrome: an attempt to assemble a medical puzzle

Plaut

2021

Preprint

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Introduction: Myofascial Pain Syndrome (MPS) is a common overlooked and underdiagnosed condition, and with significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease. Methods: Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro and medrXiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews. Findings: 734 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence. Interpretation: MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue, or "fascial armoring", which may explain pain, distribution of pain, decreased pressure/pain threshold, and other phenomena eg, occasional complete resolution after surgery. Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. MPS should no longer be overlooked but solidified in the domain of common modern medicine.

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“…20 Due to the percutaneous nature of the procedure neurovascular bundles are at risk of injury however one recent study has reported no significant neurovascular damage in 54 patients and only one transient dysesthesia. 22 The main issue for this technique is the significantly high recurrence rate ranging from 9 to 75% at five years. 23,24 Needle fasciotomy is generally agreed to have a role in managing MCPJ contractures, however it is less favorable in cords causing PIPJ contractures due to inability to reproducibly divide these cords and their proximity to the digital nerves.…”

Section: Operative Management 231 Needle Fasciotomymentioning

confidence: 99%

Dupuytren’s Contracture – Current Concepts

Dutta

Jayasinghe

Deore

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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Analysis of recurrence and complications after percutaneous needle fasciotomy in Dupuytren’s disease

Cited by 11 publications

References 31 publications

Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle

Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle

Scoping review and interpretation of Myofascial Pain/Fibromyalgia syndrome: an attempt to assemble a medical puzzle

Dupuytren’s Contracture – Current Concepts

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