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OrthoVellum

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Hand & Upper Limb
intermediate
X-Type

Dupuytren's Disease - Palmar Fascia Pathology, Tubiana Classification and Fasciectomy

Hand Disorders

A 62-year-old man of Northern European descent presents with progressive inability to fully extend his ring and little fingers. He noticed nodules in his palm 5 years ago which have gradually developed into thick cords. Examination reveals palmar nodules, palpable cords along the ring and little finger rays, and fixed flexion contractures at the MCP joints (30 degrees ring finger, 45 degrees little finger) and PIP joints (20 degrees each). There is no PIPJ flexion contracture. He asks about the cause, natural history, and treatment options including the risks and recurrence rates of surgery. Regarding Dupuytren's disease:

Mark each as TRUE or FALSE

A

Dupuytren's disease is a benign FIBROPROLIFERATIVE disorder of the PALMAR FASCIA characterized by MY...

B

Pathology progresses through three phases: PROLIFERATIVE (nodule formation with myofibroblasts), INV...

C

Dupuytren's affects the FLEXOR TENDONS directly; it is most common in AFRICAN populations; the thumb...

D

TUBIANA CLASSIFICATION grades contracture severity (total passive extension deficit): Stage 0 = 0 de...

E

Treatment options: FASCIECTOMY (selective removal of diseased fascia - most common, 20-50% recurrenc...

Answer the questions to see explanations

Click T (True) or F (False) for each option