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[PMID]: 29519629
[Au] Autor:Sanjuán-Cerveró R; Vazquez-Ferreiro P; Gómez-Herrero D; Carrera-Hueso FJ; Fikri-Banbrahim N
[Ad] Address:Servicio de Cirugía Ortopédica y Traumatología, Hospital de Denia, Denia, Alicante, España. Electronic address: sanjuan.rafcer@gmail.com.
[Ti] Title:Evolución al año de tratamiento con CCH para la contractura de Dupuytren: estudio prospectivo. One year follow-up after treatment with CCH for Dupuytren's disease: A prospective view.
[So] Source:Rev Esp Cir Ortop Traumatol;, 2018 Mar 05.
[Is] ISSN:1988-8856
[Cp] Country of publication:Spain
[La] Language:eng; spa
[Ab] Abstract:Aim Clostridium histolyticum collagenase (CCH) is nowadays an alternative treatment for the contracture of Dupuytren. Our objective is to assess its effectiveness at one year in a series of consecutive patients. MATERIAL AND METHOD: Prospective study with minimum follow-up of one year. Evaluation of results and adverse effects. RESULTS: A total of 75 joints treated in 51 patients were included. The average age was 65.18years (SD: 7.288) and 82.7% were males. The initial mean contraction of the MCP was 34.0 degrees (SD: 27.37), PIP 41.5 degrees (SD: 31.33) and combined impairment (MCF+IFP) of 75.5 degrees (SD: 35.2). Efficacy was achieved in 68 patients (90.7%). Adverse effects were mild and self-limiting. The mean correction for the MCP joint was 28.96 degrees (SD: 26.90) and for PIP it was 28.72 degrees (SD: 24.30). The recurrence rate was 18 (24.0%) joints in 14 patients, being more frequent in severe cases. QuickDASH score showed minimal differences measured before the intervention and once a year. DISCUSSION: Our results show a better outcome in mild cases; the outcome was more favourable and with a higher success rate in the MCP joint. QuickDASH score is not a useful tool for the assessment of Dupuytren's contracture. CONCLUSIONS: Treatment with CCH for Dupuytren's contracture is an effective treatment in the medium term. It has a poorer outcome in combined joint disorders, 5th finger, PIP and severe cases.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

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[PMID]: 29350502
[Au] Autor:Stepic N; Koncar J; Rajovic M
[Ti] Title:The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome.
[So] Source:Vojnosanit Pregl;74(1):19-23, 2017 Jan.
[Is] ISSN:0042-8450
[Cp] Country of publication:Serbia
[La] Language:eng
[Ab] Abstract:Background/Aim: Dupuytren's disease is a progressive disease of the palmar and digital fascial structures, with functional limitations. There are no clear recommendations about the optimal time of surgical repair, concerning the hand impairment. The aim of our study was to investigate the relation between finger's contracture degree and success of surgical treatment of the Dupuytren's disease. Methods: This prospective analysis included 60 patients operated on due to Dupuytren's contracture. According to preoperative contracture degree of proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joint, patients were divided into three groups: the group 1: < 15°, the group 2: 15−30° and the group 3: > 30°. All the patients underwent operation of partial palmar fasciectomy. Postoperative improvement was expressed with contracture reduction INDEX. Results: There were 60 patients with 85 fingers affected. The groups 1, 2 and 3 had 22 (37%), 37 (62%) and 26 (43%) fingers with MCP contracture and 32 (37.4%), 24 (28.2%) and 29 (34.1%) fingers with PIP contracture, respectively. Postoperative contractures of MCP joint in these groups were 0, 0.135° and 5°, and of PIP joint 0, 2.08 ° and 16.89°, respectively. After six months all MCP contractures resolved, while PIP joint contracture in the group 3 remained 13.62°. The reduction INDEX was 98.85%, 97.62% and 75.52% in the groups 1, 2 and 3, respectively. There was a statistically significant difference in the INDEX value between the groups (p = 0.0001). Conclusion: The degree of PIP joint contracture is related to the outcome of surgical treatment of Dupuytren's disease. Optimal results are achieved when contracture degree is between 15° and 30°. Surgical treatment of MCP joint contracture is successful regardless of the preoperative joint contracture degree.
[Mh] MeSH terms primary: Dupuytren Contracture/surgery
Fasciotomy
Finger Joint/surgery
Hand Deformities, Acquired/surgery
Metacarpophalangeal Joint/surgery
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Biomechanical Phenomena
Dupuytren Contracture/diagnosis
Dupuytren Contracture/physiopathology
Fasciotomy/adverse effects
Female
Finger Joint/physiopathology
Hand Deformities, Acquired/diagnosis
Hand Deformities, Acquired/physiopathology
Humans
Male
Metacarpophalangeal Joint/physiopathology
Middle Aged
Prospective Studies
Recovery of Function
Severity of Illness Index
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[Js] Journal subset:IM
[Da] Date of entry for processing:180120
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150331103S

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[PMID]: 29370792
[Au] Autor:Dritsaki M; Rivero-Arias O; Gray A; Ball C; Nanchahal J
[Ad] Address:Oxford Clinical Trials Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK. melina.dritsaki@ndorms.ox.ac.uk.
[Ti] Title:What do we know about managing Dupuytren's disease cost-effectively?
[So] Source:BMC Musculoskelet Disord;19(1):34, 2018 01 25.
[Is] ISSN:1471-2474
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Dupuytren's disease (DD) is a common and progressive, fibroproliferative disorder of the palmar and digital fascia of the hand. Various treatments have been recommended for advanced disease or to retard progression of early disease and to prevent deterioration of the finger contracture and quality of life. Recent studies have tried to evaluate the clinical and cost-effectiveness of therapies for DD, but there is currently no systematic assessment and appraisal of the economic evaluations. METHODS: A systematic literature review was conducted, following PRISMA guidelines, to identify studies reporting economic evaluations of interventions for managing DD. Databases searched included the Ovid MEDLINE/Embase (without time restriction), National Health Service (NHS) Economic Evaluation Database (all years) and the National Institute for Health Research (NIHR) Journals Library) Health Technology Assessment (HTA). Cost-effectiveness analyses of treating DD were identified and their quality was assessed using the CHEERS assessment tool for quality of reporting and Phillips checklist for model evaluation. RESULTS: A total of 103 studies were screened, of which 4 met the study inclusion criteria. Two studies were from the US, one from the UK and one from Canada. They all assessed the same interventions for advanced DD, namely collagenase Clostridium histolyticum injection, percutaneous needle fasciotomy and partial fasciectomy. All studies conducting a cost-utility analysis, two implemented a decision analytic model and two a Markov model approach. None of them were based on a single randomised controlled trial, but rather synthesised evidence from various sources. Studies varied in their time horizon, sources of utility estimates and perspective of analysis. The overall quality of study reporting was good based on the CHEERS checklist. The quality of the model reporting in terms of model structure, data synthesis and model consistency varied across the included studies. CONCLUSION: Cost-effectiveness analyses for patients with advanced DD are limited and have applied different approaches with respect to modelling. Future studies should improve the way they are conducted and report their findings according to established guidance for conducting economic modelling of health care technologies. TRIAL REGISTRATION: The protocol was registered ( CRD42016032989 ; date 08/01/2016) with the PROSPERO international prospective register of systematic reviews.
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1801
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[St] Status:In-Process
[do] DOI:10.1186/s12891-018-1949-2

  4 / 2261 MEDLINE  
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[PMID]: 29423783
[Au] Autor:Oliphant H; Gouws P
[Ad] Address:The Sussex Eye Hospital, Brighton and Sussex University Hospital, Eastern Road, Brighton, BN2 5BF, UK. Huw.oliphant@bsuh.nhs.uk.
[Ti] Title:Peyronie's disease and Dupuytren's contracture secondary to topical timolol.
[So] Source:Int Ophthalmol;, 2018 Feb 08.
[Is] ISSN:1573-2630
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Topical beta-blockers are a proven and safe medication used in the treatment of glaucoma and ocular hypertension. Local and systemic side effects are, however, well documented. Systemic side effects can include severe cardio-respiratory impairment, endocrine dysfunction, as well as headache and hyper-somnolence. Disorders involving fibrosis such as Peyronie's disease, Dupuytren's contracture, and retroperitoneal fibrosis are rarely described in the literature. CASE REPORT: We describe a case of a 55-year-old male patient undergoing treatment for ocular hypertension with topical timolol 0.25% to both eyes, who subsequently developed both Peyronie's disease and Dupuytren's contracture. To our knowledge, this is the first case of Dupuytren's contracture secondary to the use of topical timolol. CONCLUSIONS: Whilst uncommon, beta-blockers are known to be associated with such fibrotic conditions and have been reported with the use of topical timolol. This case serves to increase the current understanding of this association.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180209
[Lr] Last revision date:180209
[St] Status:Publisher
[do] DOI:10.1007/s10792-018-0837-y

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[PMID]: 29421069
[Au] Autor:Schreck MJ; Holbrook HS; Koman LA
[Ad] Address:Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC. Electronic address: Schreck.michaelj@gmail.com.
[Ti] Title:Technique of Dynamic Flexor Digitorum Superficialis Transfer to Lateral Bands for Proximal Interphalangeal Joint Deformity Correction in Severe Dupuytren Disease.
[So] Source:J Hand Surg Am;43(2):192.e1-192.e6, 2018 Feb.
[Is] ISSN:1531-6564
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Pseudo-boutonniere deformity is an uncommon complication from long-standing proximal interphalangeal (PIP) joint contracture in Dupuytren disease. Prolonged flexion contracture of the PIP joint can lead to central slip attenuation and resultant imbalances in the extensor mechanism. We present a technique of flexor digitorum superficialis (FDS) tendon transfer to the lateral bands to correct pseudo-boutonniere deformity at the time of palmar fasciectomy for the treatment of Dupuytren disease. The FDS tendon is transferred from volar to dorsal through the lumbrical canal and sutured into the dorsally mobilized lateral bands. This technique presents an approach to the repair of pseudo-boutonniere deformity in Dupuytren disease.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180208
[Lr] Last revision date:180208
[St] Status:In-Data-Review

  6 / 2261 MEDLINE  
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[PMID]: 29364396
[Au] Autor:Geraldes T; Carvalho R; Grunho M; Pires C; Ribeiro AC
[Ad] Address:Hospital Garcia de Orta, Departamento de Neurologia, Almada, Portugal.
[Ti] Title:"Acute Dupuytren's contracture": the answer is not always in your hands.
[So] Source:Arq Neuropsiquiatr;76(1):58, 2018 Jan.
[Is] ISSN:1678-4227
[Cp] Country of publication:Brazil
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180124
[Lr] Last revision date:180124
[St] Status:In-Data-Review

  7 / 2261 MEDLINE  
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[PMID]: 29305454
[Au] Autor:Sanjuan-Cerveró R; Carrera-Hueso FJ; Vazquez-Ferreiro P; Ramon-Barrios MA
[Ad] Address:Department of Orthopedics and Traumatology Surgery, Hospital de Denia , Partida Beniadlà, S/N, Dénia, Alicante 03700, Spain and Doctor of Pharmacy Programme, University of Granada, Granada, Spain.
[Ti] Title:Efficacy and adverse effects of collagenase use in the treatment of Dupuytren's disease: a meta-analysis.
[So] Source:Bone Joint J;100-B(1):73-80, 2018 Jan.
[Is] ISSN:2049-4408
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:AIMS: The aim of this meta-analysis was to assess the safety and efficacy of collagenase clostridium histolyticum compared with fasciectomy and percutaneous needle fasciotomy (PNF) for Dupuytren's disease. MATERIALS AND METHODS: We systematically searched PubMed, EMBASE, LILACS, Web of Science, Cochrane, Teseo and the ClinicalTrials.gov registry for clinical trials and cohort or case-control studies which compared the clinical outcomes and adverse effects of collagenase with those of fasciectomy or PNF. Of 1345 articles retrieved, ten were selected. They described the outcomes of 425 patients treated with collagenase and 418 treated by fasciectomy or PNF. Complications were assessed using inverse-variance weighted odds ratios (ORs). Clinical efficacy was assessed by differences between the means for movement of the joint before and after treatment. Dose adjustment was applied in all cases. RESULTS: Random-effects modelling showed that patients treated with collagenase had 3.24 increased odds of adverse effects compared with those treated by fasciectomy (OR 4.39) or PNF (OR 1.72,). The effect was lost when only major complications were assessed. Joint movement analysis revealed a difference between means of less than 10%, indicating equivalent clinical efficacy in the short and medium term for collagenase and fasciectomy. We were unable to analyse this for PNF due to a shortage of data. CONCLUSION: There were no significant differences in effect size between collagenase and fasciectomy. The use of collagenase was associated with a higher overall risk of adverse effects than both fasciectomy and PNF. Cite this article: 2018;100-B:73-80.
[Mh] MeSH terms primary: Dupuytren Contracture/drug therapy
Microbial Collagenase/therapeutic use
[Mh] MeSH terms secundary: Dupuytren Contracture/surgery
Fasciotomy/adverse effects
Fasciotomy/methods
Humans
Injections, Intralesional
Microbial Collagenase/administration & dosage
Microbial Collagenase/adverse effects
Minimally Invasive Surgical Procedures/methods
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Name of substance:EC 3.4.24.3 (Microbial Collagenase)
[Em] Entry month:1801
[Cu] Class update date: 180116
[Lr] Last revision date:180116
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180107
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0463.R1

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[PMID]: 29317799
[Au] Autor:Wong K; Trudel G; Laneuville O
[Ad] Address:Bone and Joint Research Laboratory, The Ottawa Hospital Rehabilitation Centre, Ottawa, Ontario.
[Ti] Title:Intra-articular collagenase injection increases range of motion in a rat knee flexion contracture model.
[So] Source:Drug Des Devel Ther;12:15-24, 2018.
[Is] ISSN:1177-8881
[Cp] Country of publication:New Zealand
[La] Language:eng
[Ab] Abstract:Objectives: A knee joint contracture, a loss in passive range of motion (ROM), can be caused by prolonged immobility. In a rat knee immobilization flexion contracture model, the posterior capsule was shown to contribute to an irreversible limitation in ROM, and collagen pathways were identified as differentially expressed over the development of a contracture. Collagenases purified from are currently prescribed to treat Dupuytren's and Peyronie's contractures due to their ability to degrade collagen. The potential application of collagenases to target collagen in the posterior capsule was tested in this model. Materials and methods: Rats had one hind leg immobilized, developing a knee flexion contracture. After 4 weeks, the immobilization device was removed, and the rats received one 50 µL intra-articular injection of 0.6 mg/mL purified collagenase. Control rats were injected with only the buffer. After 2 weeks of spontaneous remobilization following the injections, ROM was measured with a rat knee arthrometer, and histological sections were immunostained with antibodies against rat collagen types I and III. Results/conclusion: Compared with buffer-injected control knees, collagenase-treated knees showed increased ROM in extension by 8.0°±3.8° ( -value <0.05). Immunohistochemical analysis revealed an increase in collagen type III staining ( <0.01) in the posterior capsule of collagenase-treated knees indicating an effect on the extracellular matrix due to the collagenase. Collagen I staining was unchanged ( >0.05). The current study provides experimental evidence for the pharmacological treatment of knee flexion contractures with intra-articular collagenase injection, improving the knee ROM.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180112
[Lr] Last revision date:180112
[St] Status:In-Process
[do] DOI:10.2147/DDDT.S144602

  9 / 2261 MEDLINE  
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[PMID]: 29262442
[Au] Autor:Zyluk A
[Ti] Title:Isolierte Dupuytren-Kontraktur des distalen Interphalangealgelenks des Kleinfingers. Isolated Dupuytren's contracture of the distal interphalangeal joint of the little finger.
[So] Source:Handchir Mikrochir Plast Chir;, 2017 Dec 20.
[Is] ISSN:1439-3980
[Cp] Country of publication:Germany
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171220
[Lr] Last revision date:171220
[St] Status:Publisher
[do] DOI:10.1055/s-0043-124188

  10 / 2261 MEDLINE  
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[PMID]: 29170879
[Au] Autor:Simón-Pérez C; Alía-Ortega J; García-Medrano B; Rodríguez-Mateos JI; Brotat-Rodríguez M; Aguado-Hernandez H; Martín-Ferrero MA
[Ad] Address:Servicio de Traumatología, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal s/n, 47005, Valladolid, Spain. simonclarisa@yahoo.es.
[Ti] Title:Factors influencing recurrence and progression of Dupuytren's disease treated by Collagenase Clostridium histolitycum.
[So] Source:Int Orthop;, 2017 Nov 23.
[Is] ISSN:1432-5195
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:AIM OF THE STUDY: The purpose of this study was to determine the recurrence rate, possible adverse reactions and factors influencing recurrence and progression of Dupuytren's disease (DD) treated with Collagenase from Clostridium histolyticum (CCH). METHOD: This was a prospective study of 71 patients with DD treated with CCH from 2011 to February 2013, with a minimum follow-up period of four years. Clinical, functional, patient satisfaction, drug safety and factors influencing recurrence and disease progression were evaluated. RESULTS: In all patients, the rupture of the cord was achieved after the injection, reducing joint contracture. In five patients (7%) we verified the existence of disease recurrence during the follow-up. In 11 patients (15.5%) there was a disease progression. Three patients have been surgically operated on, without added surgery difficulty; the rate of recurrence and progression was higher in grades III and IV of Tubiana, in proximal interphalangeal (PIP) punctures, and was earlier in patients younger than 60 years. DISCUSSION: No serious local complications or general complications were observed with this method. The recurrence of DD, following criteria of Felici, is mainly observed in young patients with greater severity of the disease and at the PIP level. Progression is influenced by the same factors. Patients operated on after recurrence have no added difficulty in the surgical technique, as it has also been published in other studies. CONCLUSIONS: Patients with the lowest rates of recurrence and progression were those with a single cord in the metacarpophalangeal (MCP), a grade II of Tubiana, and were older than 60 years.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171124
[Lr] Last revision date:171124
[St] Status:Publisher
[do] DOI:10.1007/s00264-017-3690-0


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