The synopsis of this article focuses on the advancements in surgical and therapy management for Dupuytren’s disease. It includes treatment and various surgical and non-surgical techniques. It reviews therapy interventions including treatment of secondary problems resulting from prolonged digit flexion. It discusses the benefits, limitations and potential outcomes of the different treatment techniques to help assist the provider to link the most appropriate treatment of choice, to their patient’s specific limitations and disability. This article focuses on the research performed based on past and current treatments. This includes surgical and non-surgical interventions. The non-surgical interventions include hand therapy, radiotherapy, topical
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Surgical interventions have also shifted over the past several years. These include percutaneous needle fasciotomy (PNF), mimimally invasive needle aponeurotomy (NA), transverse incisions for segmental fasciectomy and collegians collegians histolytic (CCH) Xiaflex injections. New hand surgeons are focused on limited treatment and not so much as open surgical techniques. In a five-year study of randomized trial comparing NA versus limited fasciectomy, recurrence in the NA group was much higher and the contractures recurred significantly sooner in the NA group. There was high patient satisfaction in both groups but the patients who underwent limited fasciectomy were much more satisfied after 5 years. Despite this many patients still preferred the NA treatment of choice. Postoperative complications can include loss of flexion, hematoma, skin loss, edema, and infection. The authors also have an interest in use of steroids in the management of this disease. Amputation is also sometimes the choice of surgery as well. This article states in the past 10 years, therapy techniques for managing Dupretren’s hasn’t changed significantly. It does state that the extent and duration of recommended hand therapy post CCH injections continues to evolve. Some of the study states there is no evidence to support routine daily orthotic uses for all patients post fasciectomy. It doesn’t imply exact ineffectiveness, but there also aren't enough studies to accurately measure compliance with an orthosis or therapy program. The article states some others do support
Surgical interventions have also shifted over the past several years. These include percutaneous needle fasciotomy (PNF), mimimally invasive needle aponeurotomy (NA), transverse incisions for segmental fasciectomy and collegians collegians histolytic (CCH) Xiaflex injections. New hand surgeons are focused on limited treatment and not so much as open surgical techniques. In a five-year study of randomized trial comparing NA versus limited fasciectomy, recurrence in the NA group was much higher and the contractures recurred significantly sooner in the NA group. There was high patient satisfaction in both groups but the patients who underwent limited fasciectomy were much more satisfied after 5 years. Despite this many patients still preferred the NA treatment of choice. Postoperative complications can include loss of flexion, hematoma, skin loss, edema, and infection. The authors also have an interest in use of steroids in the management of this disease. Amputation is also sometimes the choice of surgery as well. This article states in the past 10 years, therapy techniques for managing Dupretren’s hasn’t changed significantly. It does state that the extent and duration of recommended hand therapy post CCH injections continues to evolve. Some of the study states there is no evidence to support routine daily orthotic uses for all patients post fasciectomy. It doesn’t imply exact ineffectiveness, but there also aren't enough studies to accurately measure compliance with an orthosis or therapy program. The article states some others do support