Description
In this informative presentation, Alex Kocheta introduces Nick Johnson, a consultant hand surgeon from Derby and honorary lecturer at the University of Leicester. Johnson provides an update on the current management strategies for Dupuytren's disease, a progressive fibroproliferative disorder characterized by the thickening and shortening of connective tissue cords in the palm, leading to flexion deformities of the fingers.
Johnson discusses the demographics of Dupuytren's, noting it is most prevalent among Caucasians, particularly males, and is linked to various risk factors such as age, diabetes, and manual labor. He explains the disease's pathophysiology involving abnormal myofibroblastic growth, detailing the disease's progression through three phases: proliferative, involution, and residual.
The lecture emphasizes when to intervene clinically, suggesting surgical options when certain joint contractures are present, while also addressing non-surgical treatments, including steroid injections and collagenase, which has shown effectiveness despite certain challenges in availability. Surgery remains the primary treatment modality in the UK, with options ranging from percutaneous fasciotomy to fasciectomy, both aimed at removing affected tissue. Johnson further explains the variability in recurrence rates of Dupuytren's, emphasizing ongoing clinical trials to enhance treatment protocols. Overall, this presentation offers a comprehensive overview of Dupuytren's disease, underscoring both current challenges and advancements in management.