Francis, you listed them all. The rest is possibly still quite experimental. Collagenase is not dead but not readily available either, cryotherapy has no statistical proof (just a single case for Ledderhose). Recently I heard about a laser therapy for Ledderhose. I haven't yet understood how it works but using a specific, low energy laser that does not heat the skin too much seems to be critical. The patient had been treated twice in Hamburg and said it reduced size and pain considerably. She promised more info and I hope that might become another option eventually.

Wolfgang

Dupuytren's contracture is a fixed flexion contracture of the hand where the fingers bend towards the palm and cannot be fully extended (straightened). genetic code for dupuytrens contracture It is named after the famous surgeon Baron Guillaume Dupuytren, who described an operation to correct the affliction.



The ring finger and pinky finger are the fingers most commonly affected, but Dupuytren's contracture may affect any or all of the fingers. Dupuytren's contracture progresses slowly and is usually painless. In patients with this condition, the tissues under the skin on the palm of the hand thicken and shorten so that the tendons dupuytrens contracture symptoms connected to the fingers cannot move freely. The palmar fascia dupuytrens contracture becomes hyperplastic and undergoes contracture. As a result, the affected fingers start to bend dupuytrens contracture alternatives more and more and cannot be straightened.



Incidence increases after the age of 40; at this age men are affected more often than women. After the age of 80 the distribution is about even.







Risk Factors


Regular operation of heavy machinery increases one's risk of developing Dupuytren's contracture; family history, diabetes, liver disease, alcoholism, epilepsy and pulmonary tuberculosis are also factors. Surgery of the hand may trigger growth of Dupuytren nodules and cords if an inclination existed before. Dupuytren's contracture may accompany fibrosing syndromes such as Peyronie's disease, Ledderhose's disease and Riedel's struma.







Treatment




Surgery (in cases of severe contracture)

Radiation therapy (specifically in early stages)

Needle aponevrotomy (removes the contracture)

Triamcinolone injections provide some relief


Surgical management consists of opening the dupuytrens contracture pictures skin over the affected cords of fibrous tissue, and dissecting the fascia away. The tendons can then be brought out to length. The procedure is not curative, and patients may need re-do surgery, however, the thickened fascia often invests web pictures of dupuytrens contracture the digital nerves and arteries, so there is significant risk of de-vascularization of the digit.



Treatment of Dupuytren's disease with low energy x-rays (radiotherapy) may cure Morbus Dupuytren on a long term, specfically if applied in early stages of the disease. Needle aponevrotomy is a minimal invasive technique where the nodules are punctuated to get fingers straight again. The nodules are not removed and might start growing again. Currently in phase III of FDA approval is another promising therapy, the injection of collagenase.



Information on therapies of Dupuytren's disease is also provided on the web site of the Dupuytren society, [1].








Back to the top of Dupuytrens contracture page.

Provided by wikipedia.org