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The Australian and New Zealand Journal... Apr 1990Dupuytren's contracture is a fascinating, deforming, fibrotic condition of the palmar fascia which has confounded clinicians and scientists for centuries. The aim of...
Dupuytren's contracture is a fascinating, deforming, fibrotic condition of the palmar fascia which has confounded clinicians and scientists for centuries. The aim of this paper is to place in perspective the longstanding associations of age, sex, race, hereditary factors, diabetes and alcohol consumption with the more recent novel investigations at the cellular level. In concert, the findings indicate that a number of factors may lead to the narrowing of palmar fascia microvessels, with localized ischaemia and oxygen free radical release. Oxygen free radicals are likely to damage the surrounding stroma, and stimulate fibroblast proliferation. Proliferating fibroblasts lay down collagen and contract in the lines of stress. The process is likely to encourage further microvessel ischaemia with a positive feedback effect that is consistent with the progressive nature of the condition.
Topics: Dupuytren Contracture; Female; Humans; Male; Risk Factors
PubMed: 2322211
DOI: 10.1111/j.1445-2197.1990.tb07362.x -
Journal of Hand Therapy : Official... 2018Descriptive.
STUDY DESIGN
Descriptive.
BACKGROUND
Dupuytren's contracture is a common disorder involving fibrosis of the palmar fascia. As patients are increasingly using online materials to gather health care information, it is imperative to assess the readability and appropriateness of this content. The recommended grade level for patient educational materials is seventh to eighth grade according to the National Institutes of Health. This study aims to assess the readability and content of online patient resources for Dupuytren's contracture.
PURPOSE OF THE STUDY
Evaluate readability of online patient education materials for Dupuytren's contracture.
METHODS
The largest public search engine, Google, was queried using the term "Dupuytren's contracture surgery" on February 26, 2016. Location filters were disabled, and sponsored results were excluded to avoid any inadvertent search bias. The 10 most popular Web sites were identified, and all relevant patient-directed information within 1 click from the original site was downloaded and saved as plain text. Readability was analyzed using 6 established analyses (Readable.io, Added Bytes, Ltd, UK).
RESULTS
Analysis of 10 Web sites demonstrates an average grade level of at least 11th grade (Flesch-Kincaid grade level, 10.2; Gunning-Fog grade level, 13.1; Coleman-Liau grade level, 14.4; Simple Measure of Gobbledygook grade level, 10.0; automated readability grade level, 9.7; and average grade level, 11.5). Overall Flesch-Kincaid reading ease index was 46.4, which is difficult. No single article was at the recommended reading level.
CONCLUSIONS
Online materials available for treatment of Dupuytren's contracture are above recommended reading levels and do not include a comprehensive explanation of treatment options, which may negatively impact decision making in patients seeking treatment for this condition. Surgeons and hand therapists alike should be cognizant of available online patient materials and make efforts to develop and provide more appropriate materials.
LEVEL OF EVIDENCE
V.
Topics: Comprehension; Dupuytren Contracture; Health Literacy; Humans; Internet; Patient Education as Topic; Reproducibility of Results
PubMed: 28843342
DOI: 10.1016/j.jht.2017.07.005 -
The Journal of Hand Surgery Dec 2023The objective of this study was to examine the routine pathologic examination of surgical specimens obtained during fasciectomy for Dupuytren contracture.
PURPOSE
The objective of this study was to examine the routine pathologic examination of surgical specimens obtained during fasciectomy for Dupuytren contracture.
METHODS
A total of 376 consecutive patients who underwent surgical limited fasciectomy with the excised tissue sent for histopathologic evaluation were identified. Patients were excluded for miscoded procedures, cases where no tissue was sent for pathologic review, and excisions of nodules only. Repeat surgeries in the same patient during the study period were excluded. The rates of concordant, discrepant, and discordant diagnoses were reported. Discrepant diagnoses were defined as different clinical diagnosis and pathologic diagnosis that did not change clinical management. Discordant diagnoses were defined as a different clinical diagnosis and a pathologic diagnosis that altered the treatment plan. The reference standard for final clinical decision-making was the pathologic diagnosis.
RESULTS
The prevalence of concordant diagnoses was 97.1% (365 of 376), of discrepant diagnoses was 2.9% (11 of 376), and there were no discordant diagnoses. Of 376 patients, 43 underwent previous surgical fasciectomy before the study surgery, and pathologic examination was obtained in 10 of these patients. All 10 patients had concordant diagnoses.
CONCLUSIONS
Our results suggest that routine pathologic examination did not alter the future treatment plan for patients who underwent limited fasciectomy. Discrepant diagnoses were encountered infrequently, and rarely in the setting of revision fasciectomy. Discordant diagnoses did not occur. Given the cost associated with pathologic evaluation, this raises the question of whether routine pathologic evaluation is necessary for Dupuytren surgery, where the capability of the treating surgeon to make a clinical diagnosis accurately may render confirmatory pathologic assessment redundant.
TYPE OF STUDY/LEVEL OF EVIDENCE
Diagnostic II.
Topics: Humans; Dupuytren Contracture; Fasciotomy; Reoperation; Treatment Outcome
PubMed: 35933252
DOI: 10.1016/j.jhsa.2022.04.012 -
Instructional Course Lectures 2014Dupuytren contracture is a condition that affects the palmar fascia. It most commonly affects men of northern European ancestry and initially presents at middle age. The...
Dupuytren contracture is a condition that affects the palmar fascia. It most commonly affects men of northern European ancestry and initially presents at middle age. The diseased fascia may form cords that extend into the digits, resulting in limited motion and function. Treatment is aimed at either releasing or removing the diseased cord so that the finger can extend fully. Common interventions include surgery, needle aponeurotomy, and collagenase injection. Surgery remains the gold standard in treatment and most commonly includes a limited fasciectomy. Although often successful, surgery carries inherent risks and may involve a lengthy recovery with extensive therapy. Needle aponeurotomy and collagenase injections are office-based alternatives that aim to weaken the cord and release the contracture. Needle aponeurotomy involves repeated needling along the cord in intervals and collagenase injections to dissolve a portion of the cord. Despite being less invasive, problems such as nerve and/or tendon injury, skin tears, and autoimmune reactions have been reported. Regardless of treatment, recurrence remains a concern.
Topics: Age Factors; Collagenases; Dupuytren Contracture; Fasciotomy; Humans; Sex Factors; Skin Transplantation; Treatment Outcome
PubMed: 24720301
DOI: No ID Found -
The Practitioner Dec 1952
Topics: Dupuytren Contracture; Humans
PubMed: 13003797
DOI: No ID Found -
The Journal of Bone and Joint Surgery.... Dec 1985
Topics: Aged; Dupuytren Contracture; Fascia; Fasciotomy; Female; Hand Injuries; Humans; Male; Middle Aged; Recurrence; Skin Transplantation
PubMed: 3908462
DOI: No ID Found -
Journal of Hand Therapy : Official... 1997
Review
Topics: Dupuytren Contracture; Hand; Humans
PubMed: 9116811
DOI: 10.1016/s0894-1130(97)80005-1 -
Reumatismo 2006Dupuytren's disease is a contracture of the hand derived from the retractile fibrosis of the palmar aponeurosis, that leads to a progressive deformity in flexion of...
Dupuytren's disease is a contracture of the hand derived from the retractile fibrosis of the palmar aponeurosis, that leads to a progressive deformity in flexion of fingers. It has been named from the French surgeon Guillaume Dupuytren (1777-1835), that described it in 1831. In this note it is sketched a short biography of Dupuytren and the main clinical features of the disease are described, underlining some particular aspects of therapy.
Topics: Adult; Age Factors; Aged; Dupuytren Contracture; Female; General Surgery; History, 18th Century; History, 19th Century; Humans; Male; Middle Aged; Sex Factors
PubMed: 17013443
DOI: No ID Found -
Ugeskrift For Laeger Mar 2015Dupuytren's disease is a hereditary fibroproliferative disease commonly affecting the palmar fascia of the hand, which results in progressive and irreversibly fixed... (Review)
Review
Dupuytren's disease is a hereditary fibroproliferative disease commonly affecting the palmar fascia of the hand, which results in progressive and irreversibly fixed flexion contractures of the hand. It may occur in the sole of the foot or in the penis. Generally, treatment has been up against a high frequency of complications and recurrence, but promising results are reported from less invasive treatment options, e.g. needle fasciotomy and enzymatic fasciotomy with collagenase. This is a detailed, comparative review of available non-operative and surgical treatments with focus on the enzymatic fasciotomy.
Topics: Clostridium histolyticum; Dupuytren Contracture; Humans; Injections, Intralesional; Microbial Collagenase
PubMed: 25786701
DOI: No ID Found -
The American Journal of Nursing Feb 1978
Topics: Adolescent; Adult; Child; Dupuytren Contracture; Female; Humans; Male; Middle Aged; Postoperative Care
PubMed: 246683
DOI: No ID Found