Department of Orthopaedics & Sports Medicine, University of Washington, Seattle, WA.
Section of Hand and Upper Extremity Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
J Hand Surg Am. 2021 Oct;46(10):896-906. doi: 10.1016/j.jhsa.2021.07.005. Epub 2021 Aug 25.
Dupuytren disease is a fibroproliferative disorder that affects the palmar fascia of the hand and results in varying degrees of nodule and cord formation. Over time, patients may develop progressive contractures, impairing their ability to type, to perform with fine instruments, or to participate in social activities such as shaking hands. Treatment options for Dupuytren contractures include needle aponeurotomy (NA), injection of collagenase Clostridium histolyticum (CCH) with manipulation of the digits, and surgical fasciectomy. Over the past decade, the use of CCH has increased. Recent studies have provided additional data regarding the pathophysiology, indications, outcomes, and costs associated with the treatment for Dupuytren contractures, and this review highlights these advances.
掌腱膜挛缩症是一种纤维增生性疾病,影响手部掌筋膜,导致不同程度的结节和索状形成。随着时间的推移,患者可能会出现进行性挛缩,从而影响他们打字、使用精细仪器或参与握手等社交活动的能力。掌腱膜挛缩症的治疗选择包括针刀切开术(NA)、注射胶原酶 Clostridium histolyticum(CCH)并对手指进行手法治疗,以及手术筋膜切除术。在过去的十年中,CCH 的使用有所增加。最近的研究提供了关于掌腱膜挛缩症治疗相关的病理生理学、适应证、结果和成本的更多数据,本综述重点介绍了这些进展。