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掌腱膜挛缩症:文献综述

Dupuytren's Contracture: A Review of the Literature.

作者信息

Khaliq Farihah, Orji Chijioke

机构信息

Department of Trauma and Orthopedics, Aintree University Hospital, Liverpool, GBR.

Department of Orthopedics, Liverpool University Hospitals National Health Service (NHS) Foundation Trust, Liverpool, GBR.

出版信息

Cureus. 2024 Dec 2;16(12):e74945. doi: 10.7759/cureus.74945. eCollection 2024 Dec.

Abstract

Dupuytren's contracture is a chronic condition that affects the palmar fascia, leading to progressive flexion of the fingers, particularly the ring and little fingers. This article provides an in-depth review of the current understanding of the condition and its management. Commonly seen in older men of Northern European descent, Dupuytren's can significantly impair hand function as contractures develop. The underlying mechanisms involve complex cellular processes, particularly the role of transforming growth factor-beta in promoting fibroblast activity and collagen buildup. Treatment strategies depend on the severity of the condition; nonsurgical options like collagenase injections and needle aponeurotomy are effective for early stages but often have high recurrence rates. For more advanced cases, surgical options such as limited and radical fasciectomy are considered, aiming to restore finger extension while addressing potential complications. Challenges in management include high recurrence rates and variability in disease progression, emphasizing the need for standardized assessment protocols and innovative therapeutic approaches. This review underscores the importance of early diagnosis and intervention to preserve hand function and enhance quality of life. It calls for ongoing research into targeted therapies to reduce recurrence rates.

摘要

杜普伊特伦挛缩症是一种影响掌腱膜的慢性疾病,会导致手指尤其是环指和小指逐渐屈曲。本文对目前对该疾病的认识及其治疗方法进行了深入综述。杜普伊特伦挛缩症常见于北欧血统的老年男性,随着挛缩的发展,会严重损害手部功能。其潜在机制涉及复杂的细胞过程,特别是转化生长因子-β在促进成纤维细胞活性和胶原蛋白积累中的作用。治疗策略取决于病情的严重程度;胶原酶注射和经皮穿刺腱膜切断术等非手术方法在早期有效,但复发率往往较高。对于更严重的病例,会考虑有限和根治性掌腱膜切除术等手术方法,旨在恢复手指伸展并处理潜在并发症。治疗的挑战包括高复发率和疾病进展的变异性,这凸显了标准化评估方案和创新治疗方法的必要性。这篇综述强调了早期诊断和干预对于保留手部功能和提高生活质量的重要性。它呼吁持续开展针对降低复发率的靶向治疗研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/731e/11693408/726bbbfcf2e1/cureus-0016-00000074945-i01.jpg

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