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Dupuytren's fracture dislocation ankle — Clinical Guidelines

Overview

Dupuytren's contracture primarily affects the digits, characterized by palmar fibromatosis leading to finger flexion contractures. 1

Diagnosis

Presence of palpable nodules in the palm 1

Thickened cords extending into the fingers 1

Clinical assessment often sufficient; imaging rarely needed 1

Management

First-line treatment: Surgical intervention (tendon release, fasciectomy) 1

Adjunctive treatments: Collagenase injection for early disease (percutaneous needle fasciotomy) 6

Special Populations

Black patients: Rare occurrence; consider genetic factors and comorbidities like sickle-cell trait 2 5 7

Comorbidities: Surgical and anesthetic considerations for patients with sickle-cell trait 7

Key Recommendations

Surgical intervention remains the standard treatment for Dupuytren's contracture due to its effectiveness 1 (Evidence: Strong)

Consider genetic and racial predispositions in black patients when managing Dupuytren's contracture 2 5 7 (Evidence: Moderate)

For black patients with comorbidities like sickle-cell trait, tailor surgical and anesthetic plans accordingly 7 (Evidence: Moderate)

References

1 Frank PL. An update on Dupuytren's contracture. Hospital medicine (London, England : 1998) 2001. link 2 LeFlore I, Antoine GA. Dupuytren's contracture and gouty tophi in a black patient. Journal of the National Medical Association 1991. link 3 Hueston JT, Seyfer AE. Some medicolegal aspects of Dupuytren's contracture. Hand clinics 1991. link 4 Evans RA. The aetiology of Dupuytren's disease. British journal of hospital medicine 1986. link 5 Mennen U. Dupuytren's contracture in the Negro. Journal of hand surgery (Edinburgh, Scotland) 1986. link90015-x) 6 Grace DL, McGrouther DA, Phillips H. Traumatic correction of Dupuytren's contracture. Journal of hand surgery (Edinburgh, Scotland) 1984. link90016-0) 7 Haeseker B. Dupuytren's disease and the sickle-cell trait in a female black patient. British journal of plastic surgery 1981. link90053-9) 8 Zaworski RE, Mann RJ. Dupuytren's contractures in a black patient. Plastic and reconstructive surgery 1979. link 9 Hueston JT, Hurley JV, Whittingham S. The contracting fibroblast as a clue to Dupuytren's contracture. The Hand 1976. link90052-8)

Dupuytren's fracture dislocation ankle