Treatment of Recurrent Dupuytren Disease

Kaplan, F. Thomas D.; Crosby, Nicholas E.

doi:10.1016/j.hcl.2018.03.009

Cited by 10 publications

(18 citation statements)

References 31 publications

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“…При рецидиве контрактуры либо диатезе Дюпюитрена у молодых пациентов некоторые специалисты предпочитают использовать полнослойный кожный трансплантат (ПКТ) с целью восполнения дефицита кожи после устранения контрактуры сустава пальца. Ряд исследований показали, что кожа из другого участка тела, в которой нет миофибробластов, участвующих в формировании патологических изменений в апоневрозе, препятствует прогрессированию заболевания, создавая своего рода преграду, известную в зарубежной литературе как "firebreak" [46,47,48].…”

Section: пластика полнослойным кожным трансплантатомunclassified

Skin Closure After Subtotal Aponeurectomy in Severe Dupuytren’s Contracture: Review

Idrisov¹,

Rodomanova

2022

Traumatology and Orthopedics of Russia

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Introduction. One of the significant problems of surgical treatment of Dupuytren's contracture is a deficiency of the skin as a result of suturing the wound after subtotal aponeurectomy. The size of the defect depends on the severity of the pathology. In the early stages of the disease, Z-plasty is widely used, but this method of plastic replacement does not completely cover the defect formed after surgical treatment of contracture of III-IV severity, especially when several fingers of the hand are lesioned. The purpose of the study. The purpose of the review is a comparative analysis of methods of plastic replacement of skin deficiency after subtotal aponeurectomy in patients with III-IV degree of severity of Dupuytren's contracture. Various tactics of treatment of this category of patients are described, including distraction elimination of contracture and further aponeurectomy, as well as various methods of plastic replacement of skin defects formed after resection of altered areas of palmar aponeurosis and elimination of contracture. Each of the proposed methods of surgical treatment has its advantages and disadvantages. Conclusions. An analysis of the relevant scientific literature has shown that the most common method of eliminating soft tissue deficiency after aponeurectomy is Z-plasty. However, due to an increase in the severity of the disease, its effectiveness decreases. To date, there is no consensus regarding the approach to the altered site of aponeurosis and there is no single method for eliminating tissue deficiency in the III-IV degree of the disease.

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Section: пластика полнослойным кожным трансплантатомunclassified

Skin Closure After Subtotal Aponeurectomy in Severe Dupuytren’s Contracture: Review

Idrisov¹,

Rodomanova

2022

Traumatology and Orthopedics of Russia

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“…Treatment options for the disease include pharmacological and surgical therapy, which include opening the affected fascia, percutaneous needle fasciotomy, and steroids or collagenase injection. [ 14 15 ] Contracture more than 30° in MCP joints, and more than 15° in PIP joints, is a definite indication for surgery. [ 16 ] These treatments are associated with neurovascular damage, and its recurrence rate, depending on the chosen treatment, and the disease severity has been between 8% and 66%.…”

Section: Introductionmentioning

confidence: 99%

“…[ 16 ] These treatments are associated with neurovascular damage, and its recurrence rate, depending on the chosen treatment, and the disease severity has been between 8% and 66%. [ 14 ] Surgical complications include delayed wound healing, hematoma, infection, swelling at the surgical site, and inability to bend the fingers. [ 17 ]…”

Section: Introductionmentioning

confidence: 99%

The effect of shock wave therapy on improving the symptoms and function of patients with Dupuytren's contracture

et al. 2022

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“… 5 The most common treatment modality for recurrent Dupuytren contracture is open partial fasciectomy considering the significant scarring, altered anatomy, and poor definition of diseased tissue. 6 Open fasciectomy for Dupuytren contracture appears to afford greater initial correction and better visualization of nerves, arteries, and flexor tendons, whereas CCH and needle aponeurotomy have a more benign complication profile and faster recovery. 6 , 7 For the purpose of this review, CCH and needle aponeurotomy are referred to as nonsurgical treatment modalities for Dupuytren disease.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Management of Recurrent Dupuytren Contracture: A Systematic Review and Meta-analysis

Wong

Huynh

Fageeh

et al. 2021

Hand (New York, N,Y.)

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Background: With numerous treatment modalities available, it is unclear whether the treatment of recurrent Dupuytren disease is as effective as its initial treatment. We aimed to investigate the outcomes of management of recurrent Dupuytren contracture. Methods: Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, MEDLINE, Embase, PubMed, CINAHL, and Cochrane Central Register of Controlled Trials were searched from their inception to April 2020. Studies of patients aged above 18 years undergoing treatment for recurrent Dupuytren contractures were included. The Risk Of Bias In Non-randomized Studies-of Interventions tool was used for quality assessment. The study was registered with Open Science Foundation. Results: A systematic review identified 12 studies: 311 patients with 224 affected digits—index (n = 5; 2.2%), long (n = 17; 7.6%), ring (n = 57; 25.4%), small (n = 112; 50%), and unspecified (n = 33; 14.7%); of these, there were 76 metacarpophalangeal joints (MCPJ; 45.5%), 90 proximal phalangeal joints (PIPJ; 53.9%), and 1 distal interphalangeal joint (0.6%). Previous treatment included the following: percutaneous needle aponeurotomy (n = 103 of 311 patients; 33.1%), collagenase clostridium histolyticum-injection (CCH; n = 75 of 311; 24.1%), limited fasciectomy (LF) ± skin graft (n = 83 of 311; 26.7%), fasciotomy (n = 1 of 311; 0.3%), and unspecified (n = 64 of 311; 20.6%). Recurrence was treated by percutaneous needle aponeurotomy (n = 68 of 311 patients; 21.9%); CCH injection (n = 53 of 311; 17.0%); aponeurotomy or dermofasciectomy or LF (n = 176 of 311; 56.6%); ray/digit amputation (n = 8 of 311; 2.6%); and PIPJ arthrodesis (n = 6 of 293; 2.0%). Range of motion was improved by 23.31° (95% confidence interval [CI] = 13.13°-33.50°; I2 = 67%; P = .05) and 15.49° (95% CI = 2.67°-28.31°; I2 = 76%; P = .01) for MCPJ and PIPJ, respectively. Conclusions: There is low level of evidence that both surgical and nonsurgical treatments provide clinically important improvements for recurrent Dupuytren contracture.

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Treatment of Recurrent Dupuytren Disease

Cited by 10 publications

References 31 publications

Skin Closure After Subtotal Aponeurectomy in Severe Dupuytren’s Contracture: Review

Skin Closure After Subtotal Aponeurectomy in Severe Dupuytren’s Contracture: Review

The effect of shock wave therapy on improving the symptoms and function of patients with Dupuytren's contracture

Outcomes of Management of Recurrent Dupuytren Contracture: A Systematic Review and Meta-analysis

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