Full Description
Dupuytren's contractures are a very common pathology with a complex underlying pathophysiology that is associated with controversy regarding the proper treatment algorithm. Although many patients do not develop contractures, when the contractures do develop and hand function is compromised, there remain multiple important considerations when deciding on the initial or ultimate treatment for these patients. Although dermatofasciectomy with skin grafting and open fasciectomy have historically been the gold standard, less invasive procedures, including percutaneous needle aponeurotomy (NA) and clostridial collagenase injections, have been gaining popularity in recent years.
This book provides a comprehensive yet concise discussion of Dupuytren's disease, ranging from historical perspectives and background to current evidence-based medicine outcomes for treatment. It reviews the considerations for each of these treatments, as well as other innovative strategies, such as the digit widget. The goal is to focus on surgical/procedural techniques and tips to optimize outcomes, while educating readers on how to make an evidence-based decision taking into account patient outcomes and cost considerations. With a world-renowned panel of authors on this disease process, the focus is on optimizing the reader's skillset for each treatment strategy. In addition, it is also important to understand some of the granularity as it relates to historical perspectives and what previous treatments may or may not have worked (e.g., McCash technique). This book also provides perspectives of the historical background up until today as well as groundbreaking work in regard to the genetic implications it may or may not have.
Contents
Dupuytren's Contracture History and Considerations.- Pathophysiology and Genetic Considerations.- Needle Aponeurotomy: Background and Technique.- Needle Aponeurotomy: Evidence-Based Outcomes.- Collagenase Injections: Background and Technique.- Collagenase Injections: Evidence-Based Outcomes.- Open Fasciectomy: Background and Technique.- Open Fasciectomy: Evidence-Based Outcomes.- Continuous Extension Torque: Background, Technique, and Evidence-Based Outcomes.- Considerations in Revision Intervention.- When to Amputate.- Radiation Therapy in Dupuytren's Disease: Does It Work?- The Role of Steroids in Dupuytren's Disease Management.- Designing Flaps and Skin Incisions.- Skin Grafting: How and When to Do It.- Use of WALANT for Dupuytren's Contracture.- Cost Assessments and Considerations.
