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Journal of Hand Surgery (British and European Volume)
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Articles

The Palmar Fascia after Treatment by the Continuous Extension Technique for Dupuytren’s Contracture

G. BRANDES
A. MESSINA
E. REALE

From the Laboratory for Cell Biology and Electron Microscopy, Medical School of Hannover, Germany and the Hand Surgery Centre, Traumatologic and Orthopaedic Hospital of Turin, Italy

Correspondence: Dr G. Brandes, Laboratory for Cell Biology and Electron Microscopy, Medical School of Hannover, Konstanty-Gutschow-Str. 8, D-30625 Hannover, Germany.

After complete elongation using the continuous extension technique the palmar fascia of four patients with Dupuytren’s contracture was examined by light and electron microscopy and compared with non-elongated samples from 20 patients at the same clinical stage of the disease. Nodules and cords were no longer clinically recognizable after extension. The tissue contained collagen fibrils of uniform diameter (about 50 nm), densely packed in fibres parallel to the stretching force. Fine filaments (presumably proteoglycans) formed a network which was intermingled with and periodically bound to the collagen fibrils. Fibroblasts and myofibroblasts with an high biosynthetic activity and oxytalan-like microfibrils were aligned along the collagen fibres.

The results show that in Dupuytren’s disease the contracted palmar fascia reacts to external forces with neoformation and reorientation of all tissue components by myofibroblasts.

Journal of Hand Surgery (British and European Volume), Vol. 19, No. 4, 528-533 (1994)
DOI: 10.1016/0266-7681(94)90221-6
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