2. IntroductionIntroduction
Dupuytrens description 1831Dupuytrens description 1831
Plater 1614 Scandinavian literature 1700Plater 1614 Scandinavian literature 1700
Cline proposed fasciectomy in 1787Cline proposed fasciectomy in 1787
Cooper performed first fasciectomy 1822Cooper performed first fasciectomy 1822
3. EpidemiologyEpidemiology
Common in Northern Europe 16% rises to 60% inCommon in Northern Europe 16% rises to 60% in
relativesrelatives
Associations, diabetes, TB, Aids,Seizure disorders minorAssociations, diabetes, TB, Aids,Seizure disorders minor
traumatrauma
Essentially Fibroblasts converted to myofibroblastsEssentially Fibroblasts converted to myofibroblasts
4. Anatomy / PathophysiologyAnatomy / Pathophysiology
Palmar fascia triangular shape base at mcpsPalmar fascia triangular shape base at mcps
4 longitudinal bands attached to skin intrinsic muscles4 longitudinal bands attached to skin intrinsic muscles
5. Anatomy / PathophysiologyAnatomy / Pathophysiology
Begins as a palmar noduleBegins as a palmar nodule
Extends distally as a cord Type 3 collagenExtends distally as a cord Type 3 collagen
myofibroblastsmyofibroblasts
6. ClinicalClinical
Nodule / contractureNodule / contracture
Activities of daily livingActivities of daily living
Knuckle padsKnuckle pads
Ledderhose Peyronies diseaseLedderhose Peyronies disease
Other assoc CTS Trigger fingerOther assoc CTS Trigger finger
Differentiation from BoutonniereDifferentiation from Boutonniere
7. Non operative treatmentNon operative treatment
Steroids Anti-inflamatoriesSteroids Anti-inflamatories
Clostridium collegenaseClostridium collegenase
Mainstay of treatment remains surgicalMainstay of treatment remains surgical
8. Surgical IndicationsSurgical Indications
Activities of daily living, Table top testActivities of daily living, Table top test
MCP > 30 degree contractueMCP > 30 degree contractue
PIP > 20 Degree contracturePIP > 20 Degree contracture