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Contratura de Dupuytren

Última revisão: 20 Aug 2025
Última atualização: 14 Jul 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • sexo masculino com idade >40 anos
  • dificuldades com atividades manuais
  • nódulo palmar
  • alterações na pele palmar
  • cordas pré-tendinosas
  • contratura da articulação metacarpofalângica
  • contratura da articulação interfalangiana proximal (IFP)
  • teste de Hueston positivo
Detalhes completos

Outros fatores diagnósticos

  • comprometimento bilateral
  • nódulos de Garrod
  • comprometimento da superfície plantar dos pés
  • comprometimento do pênis
Detalhes completos

Fatores de risco

  • sexo masculino
  • idade >40 anos
  • história familiar
  • diabetes mellitus
  • ingestão elevada de bebidas alcoólicas
  • tabagismo
  • trauma
  • medicamentos anticonvulsivantes
Detalhes completos

Диагностические исследования

Исследования, проведение которых нужно рассмотреть

  • ultrassonografia da mão
Полная информация

Алгоритм лечения

ПРОДОЛЖЕНИЕ

sem contraturas das articulações metacarpofalangianas ou interfalangianas proximais (IFP)

contraturas de ≤30 graus da articulação metacarpofalângica, sem contraturas da articulação interfalangiana proximal (IFP)

contraturas de >30 graus da articulação metacarpofalângica e/ou contraturas da articulação interfalangiana proximal (IFP)

Составители

Авторы

Craig M. Rodner, MD

Assistant Professor

Department of Orthopaedic Surgery

University of Connecticut Health Center/New England Musculoskeletal Institute

Farmington

CT

Раскрытие информации

CMR declares that he has no competing interests.

Выражение благодарностей

Dr Craig M. Rodner would like to gratefully acknowledge Dr Thomas H. Trojian and Dr Daniel M. Avery, both previous contributors to this topic. THT and DMA declare that they have no competing interests.

Рецензенты

Carlos Wigderowitz, MD, PhD, FRCSEd

Senior Clinical Lecturer in Orthopaedic and Trauma Surgery

Department of Orthopaedics and Trauma Surgery

TORT Centre

Ninewells Hospital

Dundee

UK

Раскрытие информации

CW declares that he has no competing interests.

Bill Townley, MD

Specialist Registrar

Plastic Surgery

Salisbury District Hospital

Salisbury

UK

Раскрытие информации

BT is an author of a reference cited in this topic.

Zhongyu Li, MD

Assistant Professor

Orthopaedics

Wake Forest University Baptist Medical Center

Winston-Salem

NC

Раскрытие информации

ZL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Karbowiak M, Holme T, Khan K, et al. Dupuytren's disease. BMJ. 2021 Jun 4;373:n1308. Аннотация

Boe C, Blazar P, Iannuzzi N. Dupuytren contractures: an update of recent literature. J Hand Surg Am. 2021 Oct;46(10):896-906.Полный текст  Аннотация

Ketchum LD, Donahue TK. The injection of nodules of Dupuytren's disease with triamcinolone acetonide. J Hand Surg Am. 2000 Nov;25(6):1157-62. Аннотация

Badalamente MA, Hurst LC. Efficacy and safety of injectable mixed collagenase subtypes in the treatment of Dupuytren's contracture. J Hand Surg Am. 2007 Jul-Aug;32(6):767-74. Аннотация

Hurst LC, Badalamente MA, Hentz VR, et al. Injectable collagenase clostridium histolyticum for Dupuytren's contracture. N Engl J Med. 2009 Sep 3;361(10):968-79.Полный текст  Аннотация

Статьи, указанные как источники

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