Dupuytren's Disease: Current State of the Art

Abstract

Background This review article critically examines the current literature for Dupuytren's disease. Methods Five procedures are considered: dermofasciectomy, limited fasciectomy, segmental aponeurectomy, needle aponeurotomy, and collagenase injection. Studies regarding the efficacy of these treatments focus primarily on the initial degree of correction, rate of recurrence, and complications. Results No one treatment has been declared superior and substantial controversy exists. Comparison between studies has been hampered by the absence of uniform definitions for clinical success and measurable disease progression. Traditional postoperative care includes formal therapy and night splinting, but recent studies have questioned the value of these adjuncts. Conclusion The extent of involvement at which the surgeon should intervene was previously well accepted by convention, but as the paradigm shifts towards less invasive procedures, treatment may be offered at an earlier stage. Future research should be structured to recognize the value-based decision making used by patients when selecting treatment.

Dupuytren’s contracture: the status and impact of collagenase Clostridium histolyticum treatment in Austria

“…Primarily, the doctors take measurements by use of a goniometer. This is also seen in several studies including the ones by Gilpin et al (2010) and , in which the range of motion (ROM) was one of the most important postoperative outcome measures [3,36,43].…”

“…3 Asked about patient satisfaction and if it was higher with Xiapex treatment in comparison to surgery, 85% of participating doctors answered in the affirmative, whereas 15% denied this question twice. According to literature, the injection can be repeated up to three times at 30-day intervals [3,36].…”

“…According to Henry (2014), however, the recurrence rate in minimal-invasive procedures, albeit their many advantages, is by far higher compared to surgical methods, especially fasciectomy [3].…”

“…Because of the interplay of genetic predisposition, environmental factors and its special pathophysiology, a surgical excision can never be curative [1][2][3][21][22][23].…”

“…Dupuytren's disease is most prevalent among elder men of Northern European descent and is thought to be inherited autosomal dominantly with variable penetrance [2,3].…”