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Dupuytren's contracture

L S Benson1, C S Williams, M Kahle

  • 1Clinical Orthopaedic Surgery, Northwestern University Medical School, Chicago, IL, USA.

The Journal of the American Academy of Orthopaedic Surgeons
|August 6, 1998
PubMed
Summary
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Dupuytren

Area of Science:

  • Orthopedics
  • Hand Surgery
  • Fibroproliferative Disorders

Background:

  • Dupuytren's contracture is an autosomal dominant inherited fibroproliferative disorder.
  • It commonly affects older men of specific European descents.
  • Cellular mechanisms involve microvascular ischemia and growth factors promoting myofibroblast proliferation and altered collagen.

Purpose of the Study:

  • To outline current surgical and postoperative management strategies for Dupuytren's contracture.
  • To define criteria for operative intervention.
  • To discuss postoperative therapy and recurrence management.

Main Methods:

  • Review of surgical techniques, including the volar zigzag Brunner incision.
  • Emphasis on postoperative hand therapy, including active-flexion exercises and extension splinting.

Related Experiment Videos

  • Consideration of recurrence factors and management options like skin grafts.

    • Main Results:

    • Surgical intervention is indicated for contractures exceeding 30 degrees.
    • The Brunner incision offers reliable exposure and healing.
    • Early active-flexion exercises and nighttime splinting are crucial for maintaining correction and restoring function.
    • Full-thickness skin grafts may benefit patients with early recurrence.

    Conclusions:

    • Surgical treatment for Dupuytren's contracture requires careful patient selection and understanding of postoperative commitments.
    • Effective management involves appropriate surgical approach and diligent hand therapy.
    • Managing recurrence, particularly in those with Dupuytren's diathesis, is essential for long-term outcomes.