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Contratura de Dupuytren

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 14 Sep 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

Investigações diagnósticas

Investigações a serem consideradas

  • ultrassonografia da mão
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

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)

Colaboradores

Autores

Craig M. Rodner, MD

Assistant Professor

Department of Orthopaedic Surgery

University of Connecticut Health Center/New England Musculoskeletal Institute

Farmington

CT

利益声明

CMR declares that he has no competing interests.

鸣谢

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.

同行评议者

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

利益声明

CW declares that he has no competing interests.

Bill Townley, MD

Specialist Registrar

Plastic Surgery

Salisbury District Hospital

Salisbury

UK

利益声明

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

利益声明

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.

参考文献

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关键文献

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

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

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. 摘要

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. 摘要

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.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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