Dupuytren Disease-Evidence-Based Medicine: Dupuytren Contracture

Evidence-Based Medicine: Dupuytren Contracture

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Dupuytren’s disease is a condition where the connective tissue in the palm becomes thick and forms nodules and cords. Recent research on the disease has shown increased interest in genetics and molecular biology, as well as alternative treatments. Surgeons are now recognizing that Dupuytren’s disease is a treatment, not a cure, and are becoming more familiar with the basic biology of the disease in order to find non-surgical treatments. Recent studies have shed light on the role of collagen type and the importance of collagen-specific stains in evaluating Dupuytren’s disease. It has also been found that the disease is a reactive overresponse to cellular level mechanical forces, rather than a purely biochemical process. Transforming growth factor (TGF)-β is believed to play a significant role in Dupuytren’s disease and its progression. Recent studies have used compounds to inhibit the fibroproliferative process and induce myofibroblast dedifferentiation. Prevalence studies have shown that Dupuytren’s disease is more common in Caucasians and increases with age, although its association with northern European heritage is no longer supported. It is also more prevalent in people involved in heavy manual labor. Several minimally invasive treatments have been developed including collagenase injection, needle aponeurotomy, and extensive percutaneous aponeurotomy with lipografting. These methods have shown varying degrees of effectiveness in treating Dupuytren’s contracture. The overall literature on Dupuytren’s disease is spread across many journals, making it difficult for practitioners to keep up with the latest research and trends in practice recommendations.

Keywords

Dupuytren's disease

connective tissue

thickening

nodules

cords

genetics

molecular biology

alternative treatments

surgeons

non-surgical treatments