Painful nodules and cords in Dupuytren disease

The Journal of Hand Surgery
A von CampeC Meuli-Simmen

Abstract

The etiology of Dupuytren disease is unclear. Pain is seldom described in the literature. Patients are more often disturbed by impaired extension of the fingers. We recently treated a series of patients who had had painful nodules for more than 1 year, and we therefore decided to investigate them for a possible anatomical correlate. Biopsies were taken during surgery from patients with Dupuytren disease and stained to enable detection of neuronal tissue. We treated 17 fingers in 10 patients. Intraoperatively, 10 showed tiny nerve branches passing into or crossing the fibrous bands or nodules. Of 13 biopsies, 6 showed nerve fibers embedded in fibrous tissue, 3 showed perineural or intraneural fibrosis or both, and 3 showed true neuromas. Enlarged Pacinian corpuscles were isolated from 1 sample. All patients were pain free after surgery. Although Dupuytren disease is generally considered painless, we treated a series of early stage patients with painful disease. Intraoperative inspection and histological examination of tissue samples showed that nerve tissue was involved in all cases. The pain might have been due to local nerve compression by the fibromatosis or the Dupuytren disease itself. We, therefore, suggest that the indica...Continue Reading

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Citations

Dec 10, 2015·The Cochrane Database of Systematic Reviews·Jeremy N RodriguesTim Davis
Dec 21, 2018·The Journal of Hand Surgery, European Volume·Paul StirlingJane E McEachan
May 17, 2017·The Journal of Hand Surgery Asian-Pacific Volume·Isidro JiménezJosé Medina
Jun 4, 2019·The Journal of Hand Surgery, European Volume·Isabella FassolaSenat Krasnici
Apr 8, 2014·JBJS Reviews·Scott RiesterSanjeev Kakar
Oct 13, 2020·Journal of Plastic Surgery and Hand Surgery·Tiffany L HeldAmy T Moeller
Sep 4, 2019·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Christina TuressonBarbro Krevers
Jul 6, 2021·International Journal of Women's Dermatology·Victoria J StojShari R Lipner

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