Dupuytren's contracture Treatment

Dupuytren's contracture
Treatment
In the early stages of disease when metacarpophalangeal joint contracture is below 15 degrees and there is sickness interphalangeal contracture can be treated medically.
Medical therapy. Multiple therapies have been tried: creams with vitamin E, allopurinol, colchicine, physical therapy and ultrasound, some without success. Topical retinoids have proved effective, topical corticosteroids, calcium channel blockers, tamoxifen. Therapies are still under study: Acetate Intralesional injections of triamcinolone in Colagenazo-enzyme-fasciomiotomia intralesional collagenase-injected -Ilomastat promising agent that inhibits fibroblast matrix formation 5-fluorouracil decreases collagen formation by inhibiting fibroblast differentiation and miofibroblastelor -Radiation Immunomodulator imiquimod, which decreases TNF-alpha and fibroblast growth by lowering IL2 infiba Botulinum toxin-inflammatory pathway inhibits the activation of IL2 intralesional.
Surgical therapy. Surgery is indicated when the contraction is over 20 metacarpofalangiana joint degrees and over 30 degrees at the interphalangeal. Surgical methods include: Involves excision-fasciectomia-palmar fascia -Fasciomiotomia-limited incisions, diseased tissue is removed but not incised. Complications of surgery include infection, damage to arteries, nerves, carpal tunnel syndrome, hematoma formation, wound necrosis, scar contraction. Regional pain syndrome known as reflex dystrophy simpatico occurs in 10% of patients who have surgery.
Prognosis. Dupuytren's contracture Treatment Spontaneous resolution without treatment does not appear. Progression is unpredictable and not all cases anatomic deformation progresses. Patients with early onset disease tend to present the picture more aggressive, often requiring surgery. The rate of recurrence is related to disease severity, multiple lesions and coexistent diabetes. Postoperative recurrence rate is 60%.