Dupuytren’s contracture is a fibroproliferate disease where collagen accumulates in the palmar fascia of the hand. That is to say, It leads to the formation of cords and nodules which leaves an irreversible fixed flexion contracture of the hand. In fact, Dupuytren’s contracture is not limited to hands, it may occur in the foot sole or penis.
Ways to treat Dupuytren’s contracture:
Surgery is the major approach to treat Dupuytren’s contracture, yet non surgical treatments exist. Nonetheless, Limited fasciectomy is the most common treatment and it’s a non surgical approach. Indeed, the methods used are challenging, where all has benefits and drawbacks.
-Percutaneous needle anoneurotomy (PNA)
-Collagenase Clostridium Histolyticum (CCH)
-Botulinum toxin A
CCH is a non surgical method, where the enzyme is injected into the Dupuytren’s cord, then the contracture is bloated by manual rupturing.
Comparing limited fasciectomy (LF) to percutaneous needle aponeurotomy (PNA):
LF and PNA were compared regarding the treatment they offer to patients and the results are as follows:
-PNA: Early recurrence, faster recovery and hardly any complications
-LF: Late recurrence, Slower recovery and more complications
Comparing percutaneous needle aponeurotomy (PNA) and collagenase clostridium histolyticum (CCH):
Markedly, both PNA and CCH has treated the patient’s equally with only few complications such as skin tears, edema, ecchymosis, pruritus and lymphadenopathy.
Complications of Dupuytren's contracture treatments:
-Recurrence of contracture
-Digital nerve damage or postoperative neurataxia
-Flexor tension injury or rupture
-Skin necrosis or long healing duration
-Dysvascular digit or arterial injury
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