dupuytrens

Surgery

Indications 

 

1. Significant functional impairment

 

2. PIPJ contracture

- originally thought to intervene early

- Macfarlane showed residual FFD always about 30o

- may need to release  check rein ligaments / accessory collateral ligaments

 

3. MCPJ contracture >30o

 

4. Trigger fingers

- must do limited fasciectomy 

Background

Definition Dupuytrens

 

Palmar Fibromatosis 

 

Aetiology

 

AD with variable penetration

 

Pathogenesis

 

Murrell's Theory of Pathogenesis

 

1. Microvascular ischaemia