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The Journal of Hand Surgery Oct 2017To determine the role of night orthosis use after surgical correction of Dupuytren contracture. (Review)
Review
PURPOSE
To determine the role of night orthosis use after surgical correction of Dupuytren contracture.
METHODS
We searched MEDLINE, EMBASE, CINAHL, AMED, OTSeeker, and CENTRAL for articles published from inception of the databases to August 2015. Assessment was undertaken by 2 independent reviewers (O.A.S. and S.A.). Methodological quality of randomized controlled trials was assessed using the Cochrane risk of bias tool and the Newcastle-Ottawa instrument.
RESULTS
Seven studies met the standard for inclusion in this review. A total of 659 patients across these 7 studies were included in the analysis, with follow-up ranging from 3 to 72 months. None of the included studies assessed recurrence. The analysis revealed no significant improvement in range of motion of hand joints for patients who received a static night orthosis after Dupuytren surgery compared with patients without an orthosis. Similarly, no differences were found in patient-reported functional status across the 2 groups.
CONCLUSIONS
The current literature does not appear to support the use of static night orthosis in addition to hand therapy after surgical correction of Dupuytren contracture.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV.
Topics: Dupuytren Contracture; Humans; Orthotic Devices
PubMed: 28867249
DOI: 10.1016/j.jhsa.2017.06.100 -
ANZ Journal of Surgery Apr 2020
Topics: Aged; Dissection; Dupuytren Contracture; Finger Joint; Humans; Male; Microbial Collagenase; Middle Aged; Treatment Outcome
PubMed: 31264362
DOI: 10.1111/ans.15317 -
Journal of Hand Surgery (Edinburgh,... Aug 1991
Topics: Dupuytren Contracture; Fibroblasts; Humans
PubMed: 1960484
DOI: 10.1016/0266-7681(91)90044-o -
American Family Physician Jul 2007Dupuytren's disease is a progressive condition that causes the fibrous tissue of the palmar fascia to shorten and thicken. The disease is common in men older than 40... (Review)
Review
Dupuytren's disease is a progressive condition that causes the fibrous tissue of the palmar fascia to shorten and thicken. The disease is common in men older than 40 years; in persons of Northern European descent; and in persons who smoke, use alcohol, or have diabetes. Patients present with a small, pitted nodule (or multiple nodules) on the palm, which slowly progresses to contracture of the fingers. The disease initially can be managed with observation and nonsurgical therapy. It will regress without treatment in approximately 10 percent of patients. Steroid injection into the nodule has been shown to reduce the need for surgery. Surgical referral should be made when metacarpophalangeal joint contracture reaches 30 degrees or when proximal interphalangeal joint contracture occurs at any degree. Timing of surgical intervention varies, but surgery is usually performed when the metacarpophalangeal joint contracture exceeds 40 degrees or when the proximal interphalangeal joint contracture exceeds 20 degrees. In-office percutaneous needle aponeurotomy is an alternative to surgery.
Topics: Adrenal Cortex Hormones; Diagnosis, Differential; Dupuytren Contracture; Humans; Orthopedic Procedures; Risk Factors
PubMed: 17668844
DOI: No ID Found -
Lakartidningen May 2019
Topics: Algorithms; Diagnosis, Differential; Dupuytren Contracture; Ganglion Cysts; Humans; Sick Leave; Trigger Finger Disorder; Wrist Joint
PubMed: 31192400
DOI: No ID Found -
Materia Medica Polona. Polish Journal... 1985
Review
Topics: Dupuytren Contracture; Humans; Postoperative Complications
PubMed: 3914584
DOI: No ID Found -
Journal of Hand Surgery (Edinburgh,... Aug 1999Histologically, Dupuytren's disease has been compared to the process of neoplasia because of fibroblast proliferation, recurrence, chromosomal abnormalities and... (Review)
Review
Histologically, Dupuytren's disease has been compared to the process of neoplasia because of fibroblast proliferation, recurrence, chromosomal abnormalities and antigenic profiles. However, a comparison of Dupuytren's tissue with the granulation tissue formed in wound healing could be more valid. Histology reveals similarities in cell types, proliferation, vascularity and collagen morphology. Pharmacologically, both tissues have a similar range of agonist and antagonist responses. Biochemical analysis reveals new collagen synthesis, an increased ratio of type III to type I collagen, and similar changes of the ground substance in both processes. Considering such similarities perhaps it is possible to regard some of the models used for the investigation of wound healing and granulation tissue as the missing experimental "model" for the study of Dupuytren's disease. Recently great strides have been made in the basic understanding of wound biology, and such a comparison might well provide novel therapeutic options for Dupuytren's disease.
Topics: Dupuytren Contracture; Granulation Tissue; Humans; Wound Healing
PubMed: 10473143
DOI: 10.1054/jhsb.1999.0207 -
Trends in Molecular Medicine Mar 2023We review the biology of Dupuytren's disease (DD), a common localised fibrotic disorder of the hand. The disease develops through a complex interplay of genetic and... (Review)
Review
We review the biology of Dupuytren's disease (DD), a common localised fibrotic disorder of the hand. The disease develops through a complex interplay of genetic and environmental factors, and epigenetic signalling. The early-stage disease nodules comprise a complex milieu of stromal and immune cells which interact to promote disease development. Recently, inhibition of tumour necrosis factor (TNF) locally resulted in softening and a decrease in nodule size, potentially controlling disease progression. Unlike fibrotic disorders of the visceral organs, the easy access to tissue in DD patients enables dissection of the cellular landscape and molecular signalling pathways. In addition, the study of DD may have wider benefits in enhancing our understanding of less-accessible fibrotic tissues.
Topics: Humans; Dupuytren Contracture; Signal Transduction; Tumor Necrosis Factor-alpha
PubMed: 36566101
DOI: 10.1016/j.molmed.2022.12.001 -
Arthritis Research & Therapy 2011Dupuytren's disease (DD) is an ill-defined fibroproliferative disorder of the palm of the hands leading to digital contracture. DD commonly occurs in individuals of... (Review)
Review
Dupuytren's disease (DD) is an ill-defined fibroproliferative disorder of the palm of the hands leading to digital contracture. DD commonly occurs in individuals of northern European extraction. Cellular components and processes associated with DD pathogenesis include altered gene and protein expression of cytokines, growth factors, adhesion molecules, and extracellular matrix components. Histology has shown increased but varying levels of particular types of collagen, myofibroblasts and myoglobin proteins in DD tissue. Free radicals and localised ischaemia have been suggested to trigger the proliferation of DD tissue. Although the existing available biological information on DD may contain potentially valuable (though largely uninterpreted) information, the precise aetiology of DD remains unknown. Systems biology combines mechanistic modelling with quantitative experimentation in studies of networks and better understanding of the interaction of multiple components in disease processes. Adopting systems biology may be the ideal approach for future research in order to improve understanding of complex diseases of multifactorial origin. In this review, we propose that DD is a disease of several networks rather than of a single gene, and show that this accounts for the experimental observations obtained to date from a variety of sources. We outline how DD may be investigated more effectively by employing a systems biology approach that considers the disease network as a whole rather than focusing on any specific single molecule.
Topics: Animals; Dupuytren Contracture; Gene Expression Profiling; Humans; Proteomics; Reactive Oxygen Species; Systems Biology
PubMed: 21943049
DOI: 10.1186/ar3438 -
Plastic and Reconstructive Surgery Apr 2008After reviewing this article, the participant should be able to: 1. Describe the condition of Dupuytren's disease in its various presentations and severity. 2. Describe... (Review)
Review
LEARNING OBJECTIVES
After reviewing this article, the participant should be able to: 1. Describe the condition of Dupuytren's disease in its various presentations and severity. 2. Describe the pathologic anatomy involved in palmar and digital contractures. 3. Understand recent elucidation of relevant pathophysiology. 4. Be familiar with treatment options and the management of complications.
SUMMARY
Dupuytren's contracture is one of the most frequent conditions seen by practicing hand surgeons. Inherited in an autosomal dominant pattern, the disease is characterized by a nodular thickening of the palmar fascia metacarpophalangeal and proximal interphalangeal joints. Treatment is offered to symptomatic patients with painful nodular or disabling contracture. The most prevalent surgical procedure is limited fasciectomy of the involved abnormal structures. Recurrence is common. New treatments on the horizon include the injection of clostridial collagenase, which is now in U.S. Food and Drug Administration phase III trials.
Topics: Anesthesia; Current Procedural Terminology; Dupuytren Contracture; Fasciotomy; Fingers; Humans; Ligaments, Articular; Physical Examination; Splints; Treatment Outcome
PubMed: 18379378
DOI: 10.1097/01.prs.0000305932.46121.84