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杜普伊特伦病 资料

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能会注意到手掌出现增厚或硬化。这是由杜普伊特伦挛缩（Dupuytren’s disease）引起的，皮下组织变得紧绷且呈结节状。随着时间的推移，这些组织可能形成索条，将您的手指拉向手掌。您可能会发现难以将手掌平放在桌面上，或难以将手滑入狭窄的口袋中。

随着病情进展，您可能会感到手指有牵拉感。这通常始于环指或小指。您在执行日常任务时可能会遇到困难，例如握手、洗脸或塞衬衫下摆。随着手指向内弯曲，将手伸到背后扣文胸或扣上衣扣可能会变得具有挑战性。

疼痛并不总是主要症状，但有些人会感到不适。您可能会感到手掌压痛，尤其是在按压结节时。僵硬感通常在早晨或长时间不活动后感觉更严重。寒冷天气也可能使牵拉感更加明显。

重要的是要知道，杜普伊特伦挛缩很常见。许多被诊断出患有此病的人最终都会寻求治疗。尽管外科医生对于如何管理每个病例的最佳方式缺乏一致意见，但手术仍然是进行性挛缩的金标准治疗方法。这意味着它是长期纠正畸形并改善手部功能的最可靠方法。

如果您正在经历这些症状，您的外科医生可以评估疾病对您的手部造成了多大影响。他们会检查您伸直手指的能力以及这如何限制您的日常生活。早期识别有助于为您制定合适的治疗方案。

实际发生了什么

杜普伊特伦挛缩（Dupuytren’s disease）是一种手掌皮下组织增厚并变紧的疾病。这种称为筋膜的结缔组织充当手部的一层支撑结构。随着时间的推移，它会形成索状或带状结构，将手指拉向手掌。这一过程通常与过去的手部创伤或手部重复性劳损有关。

随着这些索状结构收紧，它们会影响伸肌机制——即帮助伸直手指的系统。其结果是导致畸形，使一个或多个手指卡在弯曲位置。您可能会发现难以将手掌平放在桌面上，或难以完成握手、戴手套等日常活动。这不仅仅是皮肤问题；它会影响控制手部运动的深层结构。

您的外科医生将评估这种收紧如何影响您的特定关节。治疗的目标是松解这些紧张的索状结构，以恢复您伸直手指的能力。对于许多患者，手术矫正可提供显著的功能益处，使您能够重新使用手部。有限筋膜切除术（limited fasciectomy，涉及切除紧张组织）被认为是进行性病例的金标准治疗方法。这种方法在功能和疾病控制方面都能带来显著的长期益处。

虽然某些治疗旨在破坏这些索状结构，但手术仍然是获得长期结果的最可靠选择。然而，重要的是要了解这些手术的并发症风险显著。您的外科医生将讨论侵入性较小的选项（如经皮筋膜切开术）是否适合您。该技术涉及使用针头来破坏紧张的组织，即使在晚期病例中，它也可能是安全且可靠的。

最终目标是改善您手部的正常功能并提高您的生活质量。通过矫正畸形，您可以减少屈肌腱上的应力，并恢复功能性活动范围。这有助于解决常伴随手部功能障碍的安全和社会问题。您的外科医生将根据您的具体需求定制治疗方案，确保您在日常生活中获得最佳结果。

我们能做什么

Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 博士根据疾病的进展程度来匹配治疗方案。患者由全科医生或物理治疗师转诊至我们的诊所。通过临床评估（包括病史、体格检查以及必要的影像学检查）确立诊断。对于长期存在的问题，我们通常首先尝试非手术治疗。这包括调整活动方式、物理治疗或手部治疗、夹板固定和注射治疗。当这些方法未能带来足够改善时，我们会考虑手术。

自我管理侧重于保持手指活动。轻柔的拉伸有助于维持灵活性，并可能减缓手掌内索带的挛缩。物理治疗旨在改善您的活动范围并增强支撑手部的肌肉。您应给予这种疗法充分的尝试。坚持每日锻炼至关重要。如果您感到疼痛，非处方止痛药或抗炎药可以帮助您保持活动。这些药物虽不能阻止疾病进展，但可使日常任务更轻松。

当保守治疗达到极限时，我们会讨论医疗或手术选项。注射治疗（如皮质类固醇）可减少特定区域的炎症和疼痛。其效果是暂时的，并不能逆转挛缩。对于晚期疾病，我们可能会提供胶原酶注射以分解紧张的索带，或进行经皮针刀筋膜切开术以松解索带。这些属于微创治疗。手术仍是进行性挛缩的金标准治疗方法。掌筋膜部分切除术是最常见的选择。它涉及切除紧张的软组织以伸直您的手指。对于晚期病例，可能会采用皮肤筋膜切除术，切除皮肤和组织，在功能恢复和疾病控制方面提供显著的长期益处。即使在晚期阶段，经皮针刀筋膜切开术也是安全可靠的，其结果可预测且令人满意，并发症风险低。部分筋膜切除术目前仍是获得长期效果最可靠的治疗方法，尽管并发症风险显著。我们将这些方案作为共同决策提出，让证据引导您的选择。

预期情况

杜普伊特伦挛缩症是一种长期疾病，手掌内增厚的组织会导致手指向内弯曲。该病通常随数年时间缓慢进展。若不进行治疗，挛缩往往持续存在并可能加重，导致难以将手平放于桌面上或插入口袋。

手术仍是进展性病例的标准治疗方法。掌筋膜部分切除术是最常见的手术方式。该手术通过切除增厚的组织来伸直手指。皮肤筋膜切除术（切除皮肤和组织）可为晚期疾病提供显著的长期益处。这两种方法均旨在改善手部功能并控制病情。

恢复期涉及僵硬和肿胀阶段。当您重新开始活动手部时，可能会感到一定程度的不适。手部功能评分（用于衡量手部功能状况）通常在术后得到改善。许多患者通过矫正畸形获得了显著的功能益处。然而，部分筋膜切除术的并发症风险显著。您应与您的外科医生讨论这些风险。

复发很常见。研究表明，治疗后的复发率较高，平均随访时间为 3.8 年。即使手术成功，关节挛缩仍可能复发。约 10% 接受胶原酶注射治疗的患者在五年内接受了手术治疗。与手术筋膜切除术相比，胶原酶治疗的长期再次干预率更高。与针刀筋膜切开术和胶原酶注射相比，筋膜切除术的再次干预率最低。

如果您曾接受过扳机指松解术，您可能更容易发生新发的杜普伊特伦挛缩症。该病症的出现时间可能早于其他人群。您的外科医生将密切监测您的手部状况，以管理任何变化。

非手术选项，如针刀筋膜切开术或胶原酶注射，可为复发性疾病提供具有临床意义的改善。这些方法的并发症风险较低。然而，随着时间的推移，它们可能需要更频繁的重复治疗。您的外科医生将帮助您选择最符合您生活方式和疾病阶段的方案。

最终目标是保持手部在日常任务中的功能性。虽然我们无法保证疾病不会复发，但我们的目标是尽可能长时间地为您提供最佳的手部功能。定期随访确保我们可根据需要调整您的治疗方案。

何时就医

如果您发现手指逐渐向内弯曲，或难以将手掌平放在桌面上，请咨询您的全科医生。如果出现休息后仍无法缓解的持续性疼痛，或手部感觉无力或不稳定，请要求专科医生进行评估。如果手指出现卡住或无力感，或症状影响您的睡眠或工作，请及时就医。这些症状突然加重也需要进行检查。早期评估有助于您的外科医生了解疾病的进展，并讨论最适合您的管理方案。

Reviewed by Dr Kieran Hirpara · 10 June 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Little agreement exists on treatment recommendations for common presentations of Dupuytren disease among international hand surgeons [1].
  • Clinically important Dupuytren's disease is common in the general population [2].
  • A majority of diagnosed individuals with Dupuytren's disease undergo treatment [2].
  • The best treatment for Dupuytren contractures continues to be fiercely debated [3].
  • Dupuytren disease is progressive [3].
  • The pace of Dupuytren disease progression is unique to each patient [3].
  • Best treatments for Dupuytren disease remain uncertain [3].
  • The literature does not provide evidence in favor of a specific procedure for Dupuytren's disease due to inconsistencies in reporting complications [4].
  • The literature lacks a standardized definition for complications in Dupuytren's disease [4].
  • Patients with Dupuytren's disease may gain significant functional benefit following surgical improvement or correction of the deformity [5].
  • There remains limited evidence to guide the management of patients with Dupuytren's contracture [6].
  • Several procedural options exist for the treatment of Dupuytren disease [7].
  • Advancements in surgical and therapy management for Dupuytren's disease include indications, surgical options, non-surgical techniques, and therapy interventions [9].
  • Dermofasciectomy appears to be a highly effective surgical intervention for advanced Dupuytren disease [14].
  • Dermofasciectomy offers substantial long-term benefits in terms of function and disease control for advanced Dupuytren disease [14].
  • Surgery remains the gold-standard treatment for progressive Dupuytren contractures [17].
  • Limited palmar fasciectomy is the most common surgical option for Dupuytren's disease [17].
  • Many treatment options exist for Dupuytren contracture, each with its own complication profile [19].
  • Surgical treatment in the form of partial or selective fasciectomy remains the most reliable method for treating Dupuytren's disease [24].
  • Partial or selective fasciectomy is the most widely used method for treating Dupuytren's disease [24].

Anatomy & Pathophysiology

  • A revised severity staging system incorporating total flexion deformity and additional clinical risk factors provides a more objective and precise method for assessing Dupuytren's disease severity and may predict surgical outcomes [8].
  • Surgery remains the gold-standard treatment for progressive Dupuytren contractures, with limited palmar fasciectomy being the most common option [17].
  • Collagenase clostridium histolyticum (CCH) is a safe, effective treatment to improve hand function in Dupuytren's contracture, with most adverse events being minor and self-resolving [25].
  • A simple staged procedure is a valid alternative in the management of severe Dupuytren's proximal interphalangeal joint (PIPJ) contracture, demonstrating reliable, reproducible correction of the deformity and acceptable patient outcomes [28].
  • Safety and social issues of hand function and quality of life have an evident association with functional recovery after surgery and hand therapy [34].
  • Hand therapy after collagenase treatment is utilized to discuss results and support recovery [35].
  • Hand therapy should acknowledge patients' individual experiences and support self-modifications and development of new skills [37].
  • The incidence of skin tears after collagenase injection does not affect patient-reported outcomes six months later, but the incidence of skin tears is significantly associated with the severity of pre-treatment finger extension deficits [38].
  • No differences were observed in self-reported upper limb disability or active range of motion between patients receiving routine night-time splinting and those receiving hand therapy only after fasciectomy or dermo-fasciectomy [39].
  • Repeat collagenase treatment of previously treated digits yields similar deformity correction and complete correction rates but a higher incidence of adverse events compared to initial treatment [40].
  • Female sex and release of more than one digit are significant predictors of developing Complex Regional Pain Syndrome (CRPS) following treatment of Dupuytren contracture [41].
  • Soft tissue distraction prior to radialization can successfully realign the carpus and wrist over the ulna, but some minor recurrence must still be expected in the mid-term [44].
  • There were no significant differences in the reduction of PIP contracture, range of motion, and patient-reported outcomes between percutaneous needle fasciotomy and collagenase treatment at 2-year follow-up [46].
  • A novel patient-specific visual analogue survey (PVS) is validated in patients treated with collagenase injection for Dupuytren's disease and is readily adaptable for use in other musculoskeletal diseases [47].
  • Clinically relevant contracture correction was comparable between limited fasciectomy (LF), percutaneous needle fasciotomy (PNF), and CCH, but CCH had a higher risk of minor complications and LF had the longest time to recurrence [48].
  • In the absence of evidence that collagenase effects on cord morphology are better than needle fasciotomy, needle fasciotomy remains the first line of treatment for an uncomplicated Dupuytren's cord at the metacarpophalangeal (MCP) joint [49].

Classification

  • Dupuytren disease is a progressive condition of genetic origin [10].
  • The pathophysiology of Dupuytren disease is multifactorial, involving myofibroblast proliferation and altered collagen matrix composition [10].
  • The prevalence of Dupuytren's disease varies extremely across different geographical locations [21].
  • It is unclear whether the geographical variation in Dupuytren's disease prevalence is due to genetic, environmental, or combined factors [21].
  • Dorsal Dupuytren's nodules are encountered only in patients with Dupuytren's disease [12].
  • Dorsal Dupuytren's nodules are especially prevalent among patients with strong diathesis [12].
  • Histological staging is a reliable method for predicting recurrence of Dupuytren's disease [23].
  • Histological Type I (proliferative) carries the highest risk of recurrence [23].
  • Histological Type III (fibrotic) carries the lowest risk of recurrence [23].
  • The revised Tubiana's staging system incorporates total flexion deformity and additional clinical risk factors to assess disease severity [8].
  • The revised Tubiana's staging system provides a more objective and precise method for assessing Dupuytren's disease severity compared to prior methods [8].
  • The revised Tubiana's staging system may predict surgical outcomes [8].
  • The URAM scale is the first patient-reported functional measure for assessing Dupuytren's disease–specific disability [15].

Clinical Presentation

  • Dupuytren disease is a progressive condition of genetic origin with a multifactorial pathophysiology involving myofibroblast proliferation and altered collagen matrix composition [10].
  • Histological specimens of Dupuytren's disease are not characterized by apoptotic cells, suggesting proliferating cells may be primed for death if they fail to receive an appropriate survival signal [22].
  • Dermal fibromatosis exists in the absence of clinical features of skin involvement, and the skin may have a greater role in the development and propagation of Dupuytren's disease than previously thought [29].
  • Clinically important Dupuytren's disease is common in the general population, with a majority of diagnosed individuals undergoing treatment [2].
  • The prevalence of Dupuytren's Disease in different geographical locations is extremely variable, and it is not clear whether this is genetic, environmental, or a combination of both [21].
  • Dorsal Dupuytren's nodules are encountered only in Dupuytren's disease patients, especially among those with strong diathesis [12].
  • Dupuytren's disease in women presents similarly to men with more severe PIP joint involvement but equivalent surgical outcomes regarding final contracture correction, recurrence, and complication rates [16].
  • There is as much unknown as known about Dupuytren's disease, and even current knowledge may not be absolutely correct [18].
  • The revised Tubiana's staging system incorporates total flexion deformity and additional clinical risk factors to provide a more objective and precise method for assessing Dupuytren's disease severity [8].
  • The URAM scale is the first patient-reported functional measure for Dupuytren's disease [15].

Investigations

  • The pace of disease progression is unique to each patient [3].
  • Dupuytren's disease in women presents similarly to men with more severe proximal interphalangeal (PIP) joint involvement but equivalent surgical outcomes regarding final contracture correction, recurrence, and complication rates [16].
  • The revised Tubiana's staging system, which incorporates total flexion deformity and additional clinical risk factors, provides a more objective and precise method for assessing Dupuytren's disease severity and may predict surgical outcomes [8].
  • Histological staging is a reliable method for predicting recurrence of Dupuytren's disease, with Type I (proliferative) having the highest risk and Type III (fibrotic) the lowest [23].
  • There is limited evidence to guide the management of patients with Dupuytren's contracture [6].
  • The best treatment for Dupuytren contractures continues to be fiercely debated, and best treatments remain uncertain [3].
  • The literature does not provide evidence in favor of a specific procedure for Dupuytren's disease due to inconsistencies in reporting complications as well as the lack of a standardized definition [4].
  • Despite extensive literature, there is as much unknown as known about Dupuytren's disease, and even current knowledge may not be absolutely correct [18].

Treatment

  • Dupuytren disease is progressive, but the pace is unique to each patient [3].
  • Therapy interventions assist in linking patient-specific problems to appropriate treatment choices [9].
  • There is a low level of evidence that both surgical and nonsurgical treatments provide clinically important improvements for recurrent Dupuytren contracture [11].
  • Segmental aponeurectomy with Z-Plasty has a role in the management of Dupuytren's disease with flexion contracture predominantly involving the MCPJ [13].
  • Limited palmar fasciectomy is the most common surgical option for Dupuytren contractures [17].
  • The recurrence rate of Collagenase Clostridium Histolyticum (CCH) is comparable to other standard treatments [20].
  • There is an absence of long-term adverse events 3 years after initial CCH treatment [20].
  • CCH is an effective and safe treatment for Dupuytren contracture [20].
  • The best available published evidence indicates that surgical treatment in the form of partial or selective fasciectomy remains the most reliable method for treating Dupuytren's disease [24].
  • CCH is a safe, effective treatment to improve hand function in Dupuytren's contracture [25].
  • Most adverse events associated with CCH are minor and self-resolving [25].
  • CCH may not provide durable contracture reduction [30].
  • CCH remains a viable nonsurgical treatment for Dupuytren's disease [30].
  • High-energy focused extracorporeal shockwave therapy relieved pain in Dupuytren's disease in a series of seven hands [31].
  • A doublemasked randomized controlled trial is warranted to elucidate the value of extracorporeal shockwave therapy in Dupuytren's disease as a non-invasive treatment option to reduce pain [31].
  • Surgical intervention for Dupuytren contractures achieves a high rate of full or almost full correction (75%) [33].

Complications

  • There is little agreement among international hand surgeons on treatment recommendations for common presentations of Dupuytren disease [1].
  • Clinically important Dupuytren's disease is common in the general population, with a majority of diagnosed individuals undergoing treatment [2].
  • The best treatment for Dupuytren contractures remains uncertain and is fiercely debated [3].
  • Dupuytren disease is progressive, but the pace of progression is unique to each patient [3].
  • The literature does not provide evidence in favor of a specific procedure for Dupuytren's disease due to inconsistencies in reporting complications [4].
  • There is a lack of a standardized definition for complications in Dupuytren's disease literature [4].
  • Patients with Dupuytren's disease may gain significant functional benefit following surgical improvement or correction of the deformity [5].
  • There remains limited evidence to guide the management of patients with Dupuytren's contracture [6].
  • The revised Tubiana's staging system incorporates total flexion deformity and additional clinical risk factors to assess disease severity [8].
  • The revised severity staging system provides a more objective and precise method for assessing Dupuytren's disease severity [8].
  • The revised severity staging system may predict surgical outcomes [8].
  • Dupuytren disease is a progressive condition of genetic origin [10].
  • Dupuytren disease has a multifactorial pathophysiology involving myofibroblast proliferation and altered collagen matrix composition [10].
  • There is a low level of evidence that both surgical and nonsurgical treatments provide clinically important improvements for recurrent Dupuytren contracture [11].
  • Dorsal Dupuytren's nodules are encountered only in Dupuytren's disease patients [12].
  • Dorsal Dupuytren's nodules are especially prevalent among patients with strong diathesis [12].
  • Dermofasciectomy appears to be a highly effective surgical intervention for advanced Dupuytren disease [14].
  • Dermofasciectomy offers substantial long-term benefits in terms of function and disease control for advanced Dupuytren disease [14].
  • Dupuytren's disease in women presents similarly to men with more severe proximal interphalangeal (PIP) joint involvement [16].
  • Women with Dupuytren's disease have equivalent surgical outcomes regarding final contracture correction, recurrence, and complication rates compared to men [16].
  • There is as much unknown as known about Dupuytren's disease despite extensive literature [18].
  • Even current knowledge about Dupuytren's disease may not be absolutely correct [18].
  • Many treatment options exist for Dupuytren contracture, each with its own complication profile [19].
  • The recurrence rate of collagenase clostridium histolyticum (CCH) treatment is comparable to other standard treatments [20].
  • There is an absence of long-term adverse events 3 years after initial CCH treatment [20].
  • CCH is an effective and safe treatment for Dupuytren contracture [20].
  • Long-term overall reintervention rates following treatment of Dupuytren contracture affecting a single digit were higher with CCH than with surgical fasciectomy [26].
  • Perceived recurrence rates following treatment of Dupuytren contracture affecting a single digit were higher with CCH than with surgical fasciectomy [26].
  • These findings compare groups with similar baseline characteristics [26].
  • At 3 months and 1 year, the outcomes of needle fasciotomy and collagenase injection are the same in Dupuytren's disease with predominantly metacarpophalangeal joint involvement [27].
  • Large-scale epidemiological studies are needed to accurately report Dupuytren's disease in the modern U.S. population [32].

Recovery

  • Histological specimens of Dupuytren's disease were not characterized by apoptotic cells, suggesting proliferating cells may be primed for death if they fail to receive an appropriate survival signal [22].
  • Patients with Dupuytren's disease of the hand may gain a significant functional benefit following surgical improvement or correction of the deformity [5].
  • Dermofasciectomy appears to be a highly effective surgical intervention for advanced Dupuytren disease, offering substantial long-term benefits in terms of function and disease control [14].
  • Hospitalization for surgery for Dupuytren's disease in France still represents a meaningful economic burden despite shortening of hospital stays over time [45].
  • There is low level of evidence that both surgical and nonsurgical treatments provide clinically important improvements for recurrent Dupuytren contracture [11].
  • The recurrence rate following treatment with Collagenase Clostridium Histolyticum (CCH) is comparable to other standard treatments [20].
  • There is an absence of long-term adverse events 3 years after initial treatment with CCH, indicating it is an effective and safe treatment for Dupuytren contracture [20].
  • Long-term overall reintervention and perceived recurrence following treatment of Dupuytren contracture affecting a single digit were higher with CCH treatment than surgical fasciectomy when comparing groups with similar baseline characteristics [26].
  • Initial evaluation of long-term recurrence rates suggests disease recurrence or progression in 4 out of 6 patients with MCP contractures and 2 patients with PIP contractures following collagenase injection [42].
  • Recurrence following collagenase injection was generally less severe than the initial contracture in the MCP group [42].
  • At 3 months and 1 year, the outcomes of needle fasciotomy and collagenase injection are the same in Dupuytren's disease with predominantly metacarpophalangeal joint involvement [27].
  • Static night splintage may have a role in the treatment of early stages of Dupuytren's disease, with greatest benefit noted in the early proliferative phase [43].
  • The Unité Rhumatologique des Affections de la Main (URAM) scale is the first patient-reported functional measure for Dupuytren's disease [15].

Key Evidence

  • [L4] Little agreement exists on treatment recommendations for common presentations of Dupuytren disease in this sample of international hand surgeons. [1] (10.1016/j.jhsa.2017.08.023)
  • [L3] Clinically important Dupuytren's disease is common in the general population, with a majority of diagnosed individuals undergoing treatment. [2] (10.1177/1753193416687914)
  • [L5] The best treatment for Dupuytren contractures continues to be fiercely debated; what is known is that Dupuytren disease is progressive, but the pace is unique to each patient, and best treatments remain uncertain. [3] (10.2106/jbjs.18.00282)
  • [L4] The literature does not provide evidence in favor of a specific procedure for Dupuytren's disease due to inconsistencies in reporting complications as well as the lack of a standardized definition. [4] (10.1016/j.hansur.2017.07.002)
  • [L4] Patients with Dupuytren's disease of the hand may gain a significant functional benefit following surgical improvement or correction of the deformity. [5] (10.1308/003588406x83104)
  • [L2] Currently there remains limited evidence to guide the management of patients with Dupuytren's contracture. [6] (10.1302/0301-620x.100b9.bjj-2017-1194.r2)
  • [L4] There are several procedural options for the treatment of Dupuytren disease. [7] (10.1177/1558944718787281)
  • [L4] The revised severity staging system, which incorporates total flexion deformity and additional clinical risk factors, provides a more objective and precise method for assessing Dupuytren's disease severity and may predict surgical outcomes. [8] (10.1007/s11552-007-9071-1)
  • [L5] The article highlights advancements in surgical and therapy management for Dupuytren's disease, reviewing indications, surgical options, non-surgical techniques, and therapy interventions to assist in linking patient-specific problems to appropriate treatment choices. [9] (10.1016/j.jht.2013.10.006)
  • [L5] Dupuytren disease is a progressive condition of genetic origin with a multifactorial pathophysiology involving myofibroblast proliferation and altered collagen matrix composition. [10] (10.5435/00124635-201112000-00005)
  • [L1] There is low level of evidence that both surgical and nonsurgical treatments provide clinically important improvements for recurrent Dupuytren contracture. [11] (10.1177/1558944721994220)
  • [L3] Dorsal Dupuytren's nodules are encountered only in Dupuytren's disease patients, especially among those with strong diathesis. [12] (10.1016/j.jhsa.2010.06.001)
  • [Paper] It has a role in the management of Dupuytren's disease with flexion contracture predominantly involving the MCPJ. [13] (10.1016/j.otsr.2019.08.016)
  • [L3] Dermofasciectomy appears to be a highly effective surgical intervention for advanced Dupuytren disease, offering substantial long-term benefits in terms of function and disease control. [14] (10.1016/j.jhsa.2025.02.007)
  • [L4] We provide the first patient-reported functional measure for Dupuytren's disease. [15] (10.1002/acr.20564)
  • [L3] Dupuytren's disease in women presents similarly to men with more severe PIP joint involvement but equivalent surgical outcomes regarding final contracture correction, recurrence, and complication rates. [16] (10.1016/j.jhsa.2007.06.015)
  • [L4] Surgery remains the gold-standard treatment for progressive Dupuytren contractures, with limited palmar fasciectomy being the most common option. [17] (10.1016/j.jhsa.2011.03.002)
  • [L5] Despite extensive literature, there is as much unknown as known about Dupuytren's disease, and even current knowledge may not be absolutely correct. [18] (10.1177/1753193417715773)
  • [L5] Many treatment options exist for Dupuytren contracture, each with its own complication profile. [19] (10.1016/j.hcl.2018.03.007)
  • [L4] The recurrence rate, which is comparable to other standard treatments, and the absence of long-term adverse events 3 years after initial treatment indicate that CCH is an effective and safe treatment for Dupuytren contracture. [20] (10.1016/j.jhsa.2012.09.028)
  • [L4] The prevalence of Dupuytren's Disease in different geographical locations is extremely variable, and it is not clear whether this is genetic, environmental, or a combination of both. [21] (10.1007/s11552-008-9160-9)
  • [L4] Histological specimens of Dupuytren's disease were not characterized by apoptotic cells, suggesting proliferating cells may be primed for death if they fail to receive an appropriate survival signal. [22] (10.1054/jhsb.1999.0251)
  • [L3] Histological staging is a reliable method for predicting recurrence of Dupuytren's disease, with Type I (proliferative) having the highest risk and Type III (fibrotic) the lowest. [23] (10.1177/1753193408103729)
  • [L5] The best available published evidence indicates that surgical treatment in the form of partial or selective fasciectomy remains the most reliable and the most widely used method for treating Dupuytren's disease. [24] (10.1016/j.jhsa.2008.05.027)
  • [L2] CCH is a safe, effective treatment to improve hand function in Dupuytren's contracture, with most adverse events being minor and self-resolving. [25] (10.1177/1558944720974119)
  • [L4] Long-term overall reintervention and perceived recurrence following treatment of Dupuytren contracture affecting a single digit were higher with CCH treatment than surgical fasciectomy when comparing groups with similar baseline characteristics. [26] (10.1016/j.jhsa.2021.05.022)
  • [L2] At 3 months and 1 year, the outcomes of needle fasciotomy and collagenase injection are the same in Dupuytren's disease with predominantly metacarpophalangeal joint involvement. [27] (10.1177/1753193415617385)
  • [L4] The simple staged procedure is a valid alternative in the management of severe Dupuytren's PIPJ contracture, demonstrating reliable, reproducible correction of the deformity and acceptable patient outcomes. [28] (10.1177/1753193412439673)
  • [L3] Dermal fibromatosis exists in the absence of clinical features of skin involvement, and we hypothesize that the skin may have a greater role in the development and propagation of Dupuytren's disease than previously thought. [29] (10.1177/1753193415601353)
  • [L4] While initially effective, CCH may not provide durable contracture reduction, but remains a viable nonsurgical treatment for Dupuytren's disease. [30] (10.1007/s11552-013-9524-7)
  • [L4] A doublemasked randomized controlled trial is warranted to elucidate the value of extracorporeal shockwave therapy in Dupuytren's disease of the hand as a non-invasive treatment option to reduce pain. [31] (10.23736/s1973-9087.18.05498-9)
  • [L3] Large-scale epidemiological studies are needed to accurately report Dupuytren's disease in the modern U.S. population. [32] (10.1007/s11552-007-9076-9)
  • [L5] Surgical intervention for Dupuytren contractures achieves a high rate of full or almost full correction (75%). [33] (10.1016/j.hcl.2018.04.002)
  • [L4] Safety and social issues of hand function and quality of life had an evident association with functional recovery. [34] (10.1016/j.jht.2014.11.006)
  • [L2] Results after 9 month follow-up, hand therapy after treatment will be presented in detail and discussed. [35] (10.1016/j.jht.2010.09.006)
  • [L4] A clinical implication for hand therapy is to acknowledge patients' individual experiences and support self-modifications and development of new skills. [37] (10.1016/j.jht.2019.04.004)
  • [L2] The incidence of skin tears after collagenase injection does not affect patient-reported outcomes six months later, but the incidence of skin tears is significantly associated with the severity of pre-treatment finger extension deficits. [38] (10.1177/1753193420941329)
  • [L1] No differences were observed in self-reported upper limb disability or active range of motion between patients receiving routine night-time splinting and those receiving hand therapy only. [39] (10.1186/1471-2474-12-136)
  • [L4] Repeat collagenase treatment of previously treated digits yields similar deformity correction and complete correction rates but a higher incidence of adverse events compared to initial treatment. [40] (10.1016/j.jhsa.2023.03.026)
  • [L3] Female sex and release of more than one digit are significant predictors of developing CRPS. [41] (10.1177/1558944720963915)
  • [L4] Initial evaluation of long-term recurrence rates suggests disease recurrence or progression in 4 out of 6 patients with MCP contractures and 2 patients with PIP contractures; however, recurrence was generally less severe than the initial contracture in the MCP group. [42] (10.1016/j.jhsa.2010.01.003)
  • [L4] This study indicates that there may be a role for static night splintage in the treatment of early stages of Dupuytren's disease, with greatest benefit noted in the early proliferative phase. [43] (10.1177/175899830200700302)
  • [L4] Soft tissue distraction prior to radialization can successfully realign the carpus and wrist over the ulna, but some minor recurrence must still be expected in the mid-term. [44] (10.1177/17531934221095681)
  • [L3] Despite shortening of hospital stays over time, hospitalization for surgery for Dupuytren's disease in France still represents a meaningful economic burden. [45] (10.1016/j.otsr.2014.05.013)
  • [L2] There were no significant differences in the reduction of PIP contracture, range of motion, and patient-reported outcomes between the two treatments. [46] (10.1016/j.jhsa.2018.06.093)
  • [L2] It is also readily adaptable for use in other diseases, particularly within musculoskeletal medicine. [47] (10.1136/jisakos-2019-000301)
  • [L1] Overall, the clinically relevant contracture correction was comparable between LF, PNF and CCH, but CCH had a higher risk of minor complications and LF had the longest time to recurrence. [48] (10.1177/17531934251338349)
  • [L2] In the absence of evidence that collagenase effects on cord morphology are better, needle fasciotomy remains the first line of treatment for an uncomplicated Dupuytren's cord at the MCP joint. [49] (10.1177/1753193417711594)

References

[1] Variation in Treatment Recommendations for Dupuytren Disease. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.08.023

[2] Prevalence and incidence of doctor-diagnosed Dupuytren’s disease: a population-based study. Journal of Hand Surgery (European Volume). 2017. DOI: 10.1177/1753193416687914

[3] Dupuytren Disease: Is Collagenase Better Than Needling?. Journal of Bone and Joint Surgery. 2018. DOI: 10.2106/jbjs.18.00282

[4] Complications after treating Dupuytren's disease. A systematic literature review. Hand Surgery and Rehabilitation. 2017. DOI: 10.1016/j.hansur.2017.07.002

[5] Management of Dupuytren's Disease – Clear Advice for an Elusive Condition. The Annals of The Royal College of Surgeons of England. 2006. DOI: 10.1308/003588406x83104

[6] Treatment of Dupuytren’s contracture. The Bone & Joint Journal. 2018. DOI: 10.1302/0301-620x.100b9.bjj-2017-1194.r2

[7] Dupuytren Disease Management Trends: A Survey of Hand Surgeons. HAND. 2018. DOI: 10.1177/1558944718787281

[8] Revised Tubiana's Staging System for Assessment of Disease Severity in Dupuytren's Disease—Preliminary Clinical Findings. HAND. 2007. DOI: 10.1007/s11552-007-9071-1

[9] Surgical and therapy update on the management of Dupuytren's disease. Journal of Hand Therapy. 2014. DOI: 10.1016/j.jht.2013.10.006

[10] Dupuytren Disease: An Evolving Understanding of an Age-old Disease. Journal of the American Academy of Orthopaedic Surgeons. 2011. DOI: 10.5435/00124635-201112000-00005

[11] Outcomes of Management of Recurrent Dupuytren Contracture: A Systematic Review and Meta-analysis. HAND. 2021. DOI: 10.1177/1558944721994220

[12] Dorsal Pads Versus Nodules in Normal Population and Dupuytren's Disease Patients. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.06.001

[13] Segmental aponeurectomy with Z-Plasty as a treatment option in Dupuytren's disease: A retrospective cohort study. Orthopaedics & Traumatology: Surgery & Research. 2019. DOI: 10.1016/j.otsr.2019.08.016

[14] A Longitudinal Analysis of 281 Cases of Dermofasciectomy Efficacy in Advanced Dupuytren Disease Cases: A 20-Year Perspective. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2025.02.007

[15] Unité Rhumatologique des Affections de la Main (URAM) scale: Development and validation of a tool to assess Dupuytren's disease–specific disability. Arthritis Care & Research. 2011. DOI: 10.1002/acr.20564

[16] Results of Surgical Treatment of Dupuytren’s Disease in Women: A Review of 109 Consecutive Patients. The Journal of Hand Surgery. 2007. DOI: 10.1016/j.jhsa.2007.06.015

[17] The Treatment of Dupuytren Disease. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2011.03.002

[18] Dupuytren’s disease: my personal view. Journal of Hand Surgery (European Volume). 2017. DOI: 10.1177/1753193417715773

[19] Complications of Treatment for Dupuytren Disease. Hand Clinics. 2018. DOI: 10.1016/j.hcl.2018.03.007

[20] Dupuytren Contracture Recurrence Following Treatment with Collagenase Clostridium Histolyticum (CORDLESS Study): 3-Year Data. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2012.09.028

[21] Epidemiological Evaluation of Dupuytren's Disease Incidence and Prevalence Rates in Relation to Etiology. HAND. 2009. DOI: 10.1007/s11552-008-9160-9

[22] Is Dupuytren’s Disease Caused by an Imbalance between Proliferation and Cell Death?. Journal of Hand Surgery. 1999. DOI: 10.1054/jhsb.1999.0251

[23] Histological Staging and Dupuytren's Disease Recurrence or Extension after Surgical Treatment: A Retrospective Study of 124 Patients. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408103729

[24] Nonoperative Treatment of Dupuytren's Disease. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2008.05.027

[25] Treatment of Dupuytren’s Contracture With Collagenase: A Systematic Review. HAND. 2021. DOI: 10.1177/1558944720974119

[26] Limited Fasciectomy Versus Collagenase Clostridium histolyticum for Dupuytren Contracture: A Propensity Score Matched Study of Single Digit Treatment With Minimum 5 Years of Telephone Follow-Up. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2021.05.022

[27] One-year results of needle fasciotomy and collagenase injection in treatment of Dupuytren’s contracture: A two-centre prospective randomized clinical trial. Journal of Hand Surgery (European Volume). 2015. DOI: 10.1177/1753193415617385

[28] Management of severe Dupuytren’s contracture of the proximal interphalangeal joint with use of a central slip facilitation device. Journal of Hand Surgery (European Volume). 2012. DOI: 10.1177/1753193412439673

[29] Skin involvement in Dupuytren’s disease. Journal of Hand Surgery (European Volume). 2015. DOI: 10.1177/1753193415601353

[30] Examining the Efficacy and Maintenance of Contracture Correction after Collagenase Clostridium Histolyticum Treatment for Dupuytren's Disease. HAND. 2013. DOI: 10.1007/s11552-013-9524-7

[31] High-energy focused extracorporeal shockwave therapy relieved pain in Dupuytren's disease: a series of seven hands. European Journal of Physical and Rehabilitation Medicine. 2020. DOI: 10.23736/s1973-9087.18.05498-9

[32] Gender Ratio of Dupuytren's Disease in the Modern U.S. Population. HAND. 2007. DOI: 10.1007/s11552-007-9076-9

[33] Fasciectomy for Dupuytren Contracture. Hand Clinics. 2018. DOI: 10.1016/j.hcl.2018.04.002

[34] Factors affecting functional recovery after surgery and hand therapy in patients with Dupuytren's disease. Journal of Hand Therapy. 2015. DOI: 10.1016/j.jht.2014.11.006

[35] Dupuytren's Contracture—Therapy and Result Following Percutaneous Fasciotomy With Xiaflex (Collagenase). Journal of Hand Therapy. 2010. DOI: 10.1016/j.jht.2010.09.006

[37] Experiences of men living with Dupuytren's disease—Consequences of the disease for hand function and daily activities. Journal of Hand Therapy. 2020. DOI: 10.1016/j.jht.2019.04.004

[38] The influence of skin tears following collagenase treatment of Dupuytren’s disease on treatment outcomes. Journal of Hand Surgery (European Volume). 2020. DOI: 10.1177/1753193420941329

[39] Night-time splinting after fasciectomy or dermo-fasciectomy for Dupuytren's contracture: a pragmatic, multi-centre, randomised controlled trial. BMC Musculoskeletal Disorders. 2011. DOI: 10.1186/1471-2474-12-136

[40] Outcomes Following Repeat Collagenase Treatment of Dupuytren Contracture. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2023.03.026

[41] Separating Fact From Fiction: A Nationwide Longitudinal Examination of Complex Regional Pain Syndrome Following Treatment of Dupuytren Contracture. HAND. 2020. DOI: 10.1177/1558944720963915

[42] Collagenase Injection as Nonsurgical Treatment of Dupuytren's Disease: 8-Year Follow-Up. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.01.003

[43] The Use of Splinting as a Non-Surgical Treatment for Dupuytren's Disease: A Pilot Study. The British Journal of Hand Therapy. 2002. DOI: 10.1177/175899830200700302

[44] Patient’s perspective of treatment in Dupuytren’s Disease: collagenase versus limited fasciectomy. Journal of Hand Surgery (European Volume). 2022. DOI: 10.1177/17531934221095681

[45] Hospitalization for Dupuytren's disease: A French national descriptive analysis, 2002 to 2009. Orthopaedics & Traumatology: Surgery & Research. 2014. DOI: 10.1016/j.otsr.2014.05.013

[46] Equivalent Treatment Effect After Percutaneous Needle Fasciotomy and Collagenase Treatment for Dupuytren Contracture: 2-Year Results of a Randomized Controlled Trial With Ultrasonographic Evaluation. The Journal of Hand Surgery. 2018. DOI: 10.1016/j.jhsa.2018.06.093

[47] Novel patient-specific visual analogue survey (PVS) is validated in patients treated with collagenase injection for Dupuytren's disease. Journal of ISAKOS. 2020. DOI: 10.1136/jisakos-2019-000301

[48] Outcomes of limited fasciectomy, needle fasciotomy and collagenase injection for Dupuytren’s disease: a systematic review and meta-analysis of individual patient data. Journal of Hand Surgery (European Volume). 2025. DOI: 10.1177/17531934251338349

[49] Ultrasonographic examination of the ruptured cord after collagenase treatment or needle fasciotomy for Dupuytren’s contracture. Journal of Hand Surgery (European Volume). 2017. DOI: 10.1177/1753193417711594

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