Dupuytrens contracture

Question 1

defintion

Answer 1

proliferative connective tissue disorder where the specialised palmar fascia undergoes hyperplasia with normal fascial bands forming nodules and cords progressing to contracture at the MCP and PIP joints

Question 2

pathology

Answer 2

proliferation of myofibroblast cells and the production of abnormal collagen (type 3 being produced instead of type)

Question 3

how many cases of dupuytrens contracture are bilateral

Answer 3

50%

Question 4

aetiology of dupuytrens

Answer 4

males are 10x more affected and it can be familial (being inherited autosomal dominantly) also has a high prevalence in north europe and scandinavia

Question 5

who mostly gets dupuytrens

Answer 5

• alcoholics with cirrhosis
• side effect of phenytoin therapy
• diabetes

Question 6

dupuytrens can also occur in other type of

Answer 6

fibromatoses such as peyronies disease and ledderhose disease

Question 7

peyronies disease

Answer 7

fibromatoses affecting the penis

Question 8

ledderhous disease

Answer 8

fibromatoses affect the plantar surfaces of the feet

Question 9

where do contractors most commonly affect

Answer 9

the ring finger and little finger

Question 10

contractures

Answer 10

up to 30 degrees of contracture can generally be tolerated at the MCP joints but involvement of the PIP joints causes stiffness and requires surgery

Question 11

surgery for dupuytrens

Answer 11

involves either removing all disease tissue (fasciectomy) or division of the cord (fasciotomy)

Question 12

severe cases of dupuytrens contracture

Answer 12

may require amputation