dupuytrens

Indications 

1. Significant functional impairment

2. PIPJ contracture

- originally thought to intervene early

- Macfarlane showed residual FFD always about 30^o

- may need to release  check rein ligaments / accessory collateral ligaments

3. MCPJ contracture >30^o

4. Trigger fingers

- must do limited fasciectomy 

Definition

Palmar Fibromatosis 

Aetiology

AD with variable penetration

Pathogenesis

Murrell's Theory of Pathogenesis

1. Microvascular ischaemia