Dupuytren’s disease in a child: a long-term evolution after surgery
We report the case of a 13-year-old girl who presented with a fibrous nodular lesion on the palm of her hand. After ultrasonographic examination, surgical resection of the skin (dermofasciectomy) was performed, and a nodular phase mass was recovered, characterized as fusocellular fibroblast proliferation in a dense collagenous stroma with a cell population consisting of parallel fascicles of densely packed fusiform cells of a fibroblast strain. No signs of encapsulation or malignant changes were observed, all of which was consistent with Dupuytren’s disease. This lesion is exceptional in childhood. Sixteen years later, the patient has not relapsed, and retains full active and passive mobility. Dupuytren’s disease in childhood must be considered in the differential diagnosis of any hard palmar lesion. Diagnostic uncertainty and the fact that a hard palmar lesion in children may be clinically indistinguishable from a malignant process mean that resection of the lesion and histological examination are required.
Previous studies indicate that patients with a more negative perception of their illness tend to respond less favorably to treatment, but little is known about whether illness perceptions differ based on the type of hand or wrist conditions. Therefore, we compared illness perceptions between patients scheduled to undergo surgery for 4 illnesses in hand surgery: carpometacarpal osteoarthritis (CMC OA), Dupuytren disease, carpal tunnel syndrome (CTS), and trigger finger syndrome (TFS). We hypothesized there would be differences in illness perception between these patient groups.
Publication date: Available online 24 October 2019Source: Joint Bone SpineAuthor(s): Maeva Ferrari, Henri Lellouche, Eric Roulot, Alain Yelnik, Thomas Bardin, Philippe Orcel, Pascal Richette, Johann Beaudreuil
Dupuytren's disease can have a significant impact on the daily lives of patients. Traditionally, treatment focused on surgical correction, but advances in rheumatic pharmacology and surgical techniques have opened up a wider scope of management options. Here the authors give a background of the disease and its treatment, while providing evidence for a link with Peyronie's disease.
Authors: Zachrisson A, Sörensen AI, Strömberg J Abstract Needle fasciotomy (NF) is a minimally invasive treatment option for Dupuytren contractures, but long-term results have indicated a high recurrence rate. This prospective study was initiated to monitor the introduction of NF in a context where limited fasciectomy had been the only treatment option, and to investigate the long-term results. The inclusion criterion was a palpable cord with a Metacarpophalangeal (MCP) and/or Proximal interphalangeal (PIP) contracture in one or more fingers. Fifty-eight fingers in 42 patients (40 male and 2 female with a...
We describe a technique to improve visualization and isolation of Dupuytren cords using a tongue depressor.
Conditions: Dupuytren's Disease; Surgical Incision Intervention: Procedure: Surgical treatment Sponsors: Ramsay Générale de Santé; Dr ROULOT Recruiting
ConclusionCurrently, the administration of this treatment is promising although long-term studies are necessary to see the real role that this drug can play in both Dupuytren ’s disease and other fibrotic disorders.
Publication date: November 2019Source: The Journal of Foot and Ankle Surgery, Volume 58, Issue 6Author(s): Jeffrey D. Lehrman, Amy L.L. Miceli, Simon G. Tabchi, Mark A. KaplanAbstractPlantar fibromatosis, also known as Ledderhose's disease, is a rare disorder of benign fibroblast proliferation involving the plantar aponeurosis (i.e., plantar fascia). Traditionally, surgical intervention has been the most common treatment for plantar fibromatosis. However, numerous studies have reported high recurrence rates of plantar fibromatosis after surgical intervention, as well as wound healing difficulties and nerve injury. Plantar ...