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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Musculoskeletal complications of diabetes include carpal tunnel syndrome, Dupuytren contracture, adhesive capsulitis, and sclerodactyly. Carpal tunnel syndrome is compression of the median nerve along its course through the carpal tunnel in the wrist. Dupuytren contracture is progressive contracture of the palmar fascial bands, resulting in finger flexion deformities. Adhesive capsulitis is commonly known as frozen shoulder, associated with shoulder pain and stiffness. Sclerodactyly is a localized thickening and tightness of the skin on the fingers or toes.
Retinoids in Keratinization Disorders
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Knuckle pads can be sporadic and rarely familial. Trauma is not an etiologic factor. The condition is characterized by keratotic and fibrotic lesions on the dorsal aspect of the fingers after the late-childhood period. Dupuytren contracture can occur rarely. Treatment is unsatisfactory, but surgery, topical steroids, salicylic acid gel, retinoids, carbon dioxide freezing, intralesional steroid, and 5-fluorouracil injections are recommended (82,83).
Disorders of bone and connective tissue
Published in Angus Clarke, Alex Murray, Julian Sampson, Harper's Practical Genetic Counselling, 2019
When no primary cause is apparent, the inheritance of Dupuytren contracture is thought to be autosomal dominant, but if this is so, one would expect severe forms due to homozygosity for such a common condition, which have not been recorded.
Percutaneous needle fasciotomy in Dupuytren contracture: a register-based, observational cohort study on complications in 3,331 treated fingers in 2,257 patients
Published in Acta Orthopaedica, 2020
Laura Houstrup Therkelsen, Simon Toftgaard Skov, Malene Laursen, Jeppe Lange
Dupuytren contracture is a benign fibroproliferative disease that affects the aponeurotic fibers in the palm, causing permanent flexion contracture of the fingers. This extension deficit may imply disability in activities of daily living for the affected patients (Wilburn et al. 2013). There is no cure for Dupuytren contracture, but several symptomatic treatment options exist. However, there is no consensus as to the optimal treatment in individual cases (McMillan et al. 2017).
Needle fasciotomy for Dupuytren’s contracture- a prospective cohort study of 58 fingers with a median follow-up of 6.5 years
Published in Journal of Plastic Surgery and Hand Surgery, 2020
A. Zachrisson, A. Ibsen Sörensen, J. Strömberg
This study showed that all fingers treated by needle fasciotomy for a Dupuytren contracture had a significant reduction of the extension deficit in the affected joints, and that half of all fingers retained a satisfying result without any need for further treatment during the follow-up time. A similar recurrence rate three years after NF has been described earlier [11], while another study have shown recurrence in 22% after five years [7] . An explanation for the discrepancy between the latter study and our results may be found in the different study designs (e.g. mixed MCP and PIP joints) and different definitions of recurrence. The definition of an extension deficit of >20° in a previously straightened finger has been generally accepted [12], and if applied to our data a total of 13 fingers (25%) had a recurrence of the contracture which corresponds well to the five-year results of the previous study on NF [7]. Despite the high recurrence rate in this study by the initial definition, a vast majority of patients with recurrent disease (75%) preferred another needle fasciotomy, which represents a slightly higher percentage compared to the five-year results presented by Van Rissjen et al [7]. While the most common adverse event was skin rupture (28%), no severe complications to NF (e.g. infections, flexor tendon or permanent nerve injuries) were seen. In a systemic review by Krefter et al, the overall complication rate for NF was 19%, which represents the lowest rate for all Dupuytren treatments and this corresponds well to our results [13]. Although the objective measurements of joint motion showed significant improvement throughout the study, a corresponding improvement could not be detected in the PROMs applied, the DASH and the Quick-DASH. Budd et al have shown that this questionnaire can detect subjective improvement in patients treated for Dupuytren’s contracture, but its sensitivity and specificity to this condition has been questioned in recent years [14].