Using Tongue Depressors as a Technique to Aid Cord Localization During Collagenase Injection For Dupuytren Disease

We describe a technique to improve visualization and isolation of Dupuytren cords using a tongue depressor.
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Techniques Source Type: research

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Abstract Collagenase injection was approved in Europe for use in the treatment of Dupuytren's disease in 2011. Reported adverse effects include skin tears, swelling, pain and complex regional pain syndrome. Here, we present a case of a rare complication of phalangeal fracture following treatment with collagenase clostridium and the resultant digital amputation. An 81-year-old man was treated for a 25-year history of progressively disabling Dupuytren's disease of his left middle and ring fingers. Nine days post-manipulation he presented with persistent pain and swelling and was diagnosed with a displaced fracture o...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
We present the case of a fit and well 62-year-old male with Dupuytren's disease in the right hand who underwent percutaneous needle fasciotomy (PNF) for a moderate flexion contracture of the right little finger. 18 months later he developed a pain-free soft tissue swelling at the distal previous needling site. A fasciectomy procedure identified a cyst within the pre-tendinous cord, which was confirmed as a dermoid inclusion cyst on histological analysis. Dermoid inclusion cysts may occur in the hands at the site of penetrating trauma but we are unaware of any report of an inclusion cyst at the site of PNF surgery. We prese...
Source: Hand Surgery - Category: Surgery Authors: Tags: J Hand Surg Asian Pac Vol Source Type: research
Sanjuan-Cervero et al.1 report that patients undergoing collagenase injections for the treatment of Dupuytren's contracture report less pain if a wrist block is performed first. Unfortunately the authors did not account for the pain of 10mls of mepivacaine being injected through two injections at the wrist.
Source: Journal of Plastic, Reconstructive and Aesthetic Surgery - Category: Cosmetic Surgery Authors: Tags: Correspondence and Communications Source Type: research
Sanjuan-Cervero et al. 1 report that patients undergoing collagenase injections for the treatment of Dupuytren's contracture report less pain if a wrist block is performed first. Unfortunately the authors did not account for the pain of 10mls of mepivacaine being injected through two injections at the wrist.
Source: Journal of Plastic, Reconstructive and Aesthetic Surgery - Category: Cosmetic Surgery Authors: Tags: Correspondence and Communications Source Type: research
The objective of this study was to evaluate the effectiveness of shock-wave therapy on patients with Dupuytren's disease of the hand. CASE SERIES: A case series study observed a total of four patients with Dupuytren's disease of the hand. All four patients had diabetes. Three patients had bilateral hand involvement. Two patients had flexion deformity. High-energy focused extracorporeal shockwave therapy was applied using a Storz Duolith SD1 (2000 impulses, 3 Hz, 1.24 mJ/mm2) in five sessions with 7 days between. Outcome measured included pain score, tender score, hand grip, and nodule size from the Michigan Hand Outco...
Source: European Journal of Physical and Rehabilitation Medicine - Category: Rehabilitation Authors: Tags: Eur J Phys Rehabil Med Source Type: research
Conclusions: Concurrent carpal tunnel release and palmar fasciectomy is not associated with an increased risk for developing complex regional pain syndrome. Patient demographics, medical comorbidities, and a history of upper extremity trauma are associated with the development of complex regional pain syndrome after surgery and should be discussed preoperatively as potential risk factors. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Hand/Peripheral Nerve: Original Articles Source Type: research
ConclusionsThe thickening of the pulleys in the flexor tendons is an easy-to-detect sign with good sensitivity for the diagnosis of PsA. Its specificity and positive predictive value are not very high; however, if it is included in a complete classification process, sonographers should report it during hand evaluations of patients with arthritis.
Source: Journal of Ultrasound - Category: Radiology Source Type: research
The role of hand therapy in the treatment of Dupuytren disease varies depending on the patient and the procedure. There is limited evidence for hand therapy as a preventive treatment of Dupuytren disease. Before corrective treatment, the hand therapist can contribute with assessments to promote evaluation of outcome. After corrective treatment, hand therapy is tailored to each patient ’s needs and consists of orthoses, exercise, edema control, and pain or scar management. Orthoses are usually part of the hand therapy protocol after corrective procedures despite lack of strong supporting evidence and should be provide...
Source: Hand Clinics - Category: Orthopaedics Authors: Source Type: research
Procedural pain is one of the most common adverse effects reported by patients with Dupuytren disease treated with collagenase clostridium histolyticum (CCH). The aim of this study was to assess the effectiveness of wrist block prior to CCH injection in reducing procedural pain and analyze its impact on adverse effects. We performed a prospective, single-centre study in which we compared two groups of patients in a consecutive cohort. In the first group (NO-BLOCK), wrist block was only performed before finger extension, while in the second group (BLOCK) it was performed before CCH injection and finger extension.
Source: Journal of Plastic, Reconstructive and Aesthetic Surgery - Category: Cosmetic Surgery Authors: Source Type: research
Patient-reported outcome measures (PROMs) have become an essential part of patient evaluation, both in clinical and research settings. The Michigan Hand Outcomes Questionnaire (MHQ) is one of the most widely-used PROM for hand-specific conditions, by therapists and surgeons alike. A brief version of the questionnaire (bMHQ) was also developed, for a clinical setting. The MHQ is composed of 6 domains: general function, ADL/IADL performance, work performance, pain, satisfaction, and aesthetics. It is the only tool to evaluate perception of the latter domain, a major component negatively affecting quality of life in condition...
Source: Journal of Hand Therapy - Category: Rehabilitation Authors: Source Type: research
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