DUPUYTREN'S
DISEASE:
FREQUENTLY ASKED QUESTIONS
AND LINKS TO PUBLISHED STUDIES: FAQS & FACTS
These pages include answers to frequently asked questions regarding
Dupuytren's disease. There is quite a bit known about Dupuytren's, but
because we don't yet have all of the pieces of the puzzle, the bits
that we do know don't all fit tidily together. There are also a fair
number of undocumented urban legends. This page only includes
information which has been investigated and published in recognized
medical journals - the stuff that doctors read. For verification and
more information, this
page links to source material at the National
Library of
Medicine. Browse around! There's quite a bit here to consider.
- Terminology -
|
MEDICAL / ENGLISH TRANSLATIONS relating to Dupuytren's Disease
- Aponeurosis same as Fascia.
- Aponeurectomy same as Fasciectomy.
- Aponeurotomy same as Fasciotomy.
- Aponevrosis same as Fascia (French
spelling).
- Aponevrotomy same as Fasciotomy (French
spelling).
- Closed
two meanings: (see open)
- A procedure performed without any
cut in the skin, as in a joint manipulation.
- At the end of surgery, a wound can be
"closed" by sewing the skin edges together or covering the area with a
skin graft or skin flap.
- Dermofasciectomy
removing fascia and the overlying affected skin.
This requires closing the wound with a skin graft or flap.
- DIP Distal
Interphalangeal
Joint. The end joint of a finger.
- Dorsal
Back side of the hand, opposite of
the palmar side.
- Extension
two meanings:
- Straightening a joint
(opposite of flexion or bending).
- After surgery, Dupuytren's
showing up adjacent to the area previously treated,
technically different than recurrence.
- Fascia
a normal reinforcing layer of tissue, found in many areas of the body.
In discussions of Dupuytren's, the fascia refers to the superficial
palmar fascia, which is a clothlike layer of tissue
beneath the skin of the palm, attached to the undersurface of the skin
above it and the bones and muscle coverings below it. The fascia
normally functions in a very similar manner to what is referred to in
the garment industry as "interfacing": a layer of
stiff cloth inside clothing which maintains the
clothing's shape (interfacing and
fascia share the same Latin root). The superficial palmar
fascia normally acts as a scaffolding which anchors
palm skin to the bones in the hand so the skin doesn't slide around
while when we grip, hold, and twist things in our hands - it maintains
the shape of the skin. The fascia is a normally unnoticeable layer, not
a moving part, and not the tendons which we use to
move our fingers. In Dupuytren's disease, it is the fascia
which shrinks and thickens, pulling on the skin,
pulling and bending the fingers. In the US, insurance companies use the
term fascia, not aponeurosis.
- Fasciectomy
surgery to remove the fascia. Don't you need the
fascia? Well, yes, but after fasciectomy, the body replaces what has
been removed with a layer of scar tissue, which usually works well.
- Fasciotomy
cutting but not removing the fascia.
This refers to cutting across tight bands of fascia, letting the edges
gape apart and heal back at or closer to their natural length to
restore the area's original flexibility.
- Hematoma blood clot. After
surgery, if much blood collects beneath the skin or beneath a skin
graft, it may result in necrosis,
or a wound where there should be skin. This slows recovery but is not
the same thing or danger as a blood clot in the legs (DVT) after
surgery.
- Longitudinal lengthwise, as
for a line drawn along the length of a finger, base to tip.
- Necrosis
dead skin. If the circulation isn't good enough to an area of skin,
after a week or so, that area of skin will turn black and hard and
eventually either fall off or need to be trimmed off. This can happen
after surgery, usually at the edges of a cut, where it is referred to
as marginal necrosis.
- Open
two meanings (see closed)
- Surgically,
open means regular surgery, where the skin is "opened" with a cut, as
in fasciectomy. A wound which can be stitched back together. Not percutaneous.
- After surgery,
when the wound is literally left open, not stitched back together.
Sounds gruesome, but it really isn't. This is what is done with the
"open palm" surgical technique for Dupuytren's
- Palmar
The palm side of the hand or fingers - not just
"the palm". Opposite of the dorsal
side.
- Patient You.
- Percutaneous
A procedure performed through a small puncture wound, using a needle,
narrow knife or scope, no stitches.
- PIP Proximal
Interphalangeal
joint, the middle joint in a finger.
- Recurrence
After surgery, Dupuytren's showing
up in the area previously treated, technically
different than extension.
- Suture stitches
- Transverse side to side,
usually refers to a sideways cut in the palm used for fasciectomy
|
|