Legge J W, Finlay J B, McFarlane R M
J Hand Surg Am. 1981 Sep;6(5):482-92. doi: 10.1016/s0363-5023(81)80109-8.
This study was designed to determine if structural changes in the palmar fascia in Dupuytren's disease, as viewed by the scanning electron microscope, might provide some information about the pathogenesis of this disease. The palmar fascia from seven uninvolved hands and from 21 patients with Dupuytren's disease was examined. There were distinct differences between normal and diseased collagen. The diseased tissue showed collagen that was more tightly bound and had a shorter wave pattern. In the Dupuytren's tissue the waves were frequently in a helix, but this was never seen in the normal tissue. The most striking differences were noted in the nodule, presumably because it appears first, followed by the cord proximal to the nodule (pretendinous cord). Similar but less obvious changes were noted in the cord distal to the nodule (central cord) presumably because it is last to form. These observations suggest a mechanism of contraction. The short wave length and helix formation of the collagen indicate shortening. If the concept of the myofibroblast as a contractile cell is accepted, the contraction of these cells in stepwise fashion could produce the changes in the structure of the collagen that have been observed and result in joint contracture.
本研究旨在确定，通过扫描电子显微镜观察，掌腱膜挛缩症患者掌腱膜的结构变化是否能为该疾病的发病机制提供一些信息。研究检查了7只未患病手以及21例掌腱膜挛缩症患者的掌腱膜。正常胶原和病变胶原之间存在明显差异。病变组织中的胶原结合更紧密，波形更短。在掌腱膜挛缩症组织中，波形常呈螺旋状，但正常组织中从未见过这种情况。在结节中观察到的差异最为显著，可能是因为结节最先出现，随后是结节近端的条索（假腱索）。在结节远端的条索（中央索）中也观察到了类似但不太明显的变化，可能是因为它最后形成。这些观察结果提示了一种收缩机制。胶原的短波长和螺旋形成表明其缩短。如果接受肌成纤维细胞作为收缩细胞的概念，这些细胞的逐步收缩可能会导致观察到的胶原结构变化，并导致关节挛缩。
