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Old 11-10-2012
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Question best initial rx for dupuytrens contracture ?

surgery or steroids ...
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Old 11-10-2012
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Steroids can be used first if the contracture is mild (that is there is not a total function impairment)

Surgical release is the only effective therapy once steroids fails or the patient presents with a disabling contracture.
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Collagenase injection
Quote:
In the double-blind portion of the phase 3 trial for this treatment—a randomized, double-blind, placebo-controlled study followed by an open-level extension—91% of patients treated with collagenase achieved clinical success.
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What about radation therapy as initial therapy mentioned in wikipedia.
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Quote:
Originally Posted by cingulate.gyrus View Post
What about radation therapy as initial therapy mentioned in wikipedia.
That's only useful to slow the progression of early disease and mainly used in Europe.

This topic is much better covered in Medscape.
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Originally Posted by Novobiocin View Post
That's only useful to slow the progression of early disease and mainly used in Europe.

This topic is much better covered in Medscape.
so verdict is to use steroids as best initial drug
but mtb's says steroids have NO role.
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Quote:
Originally Posted by tyagee View Post
so verdict is to use steroids as best initial drug
but mtb's says steroids have NO role.
MTB 2 page 177 says---Triamcinolone may help

Bottomline: Try Triamcinolone initially (or collagenase if it is one of the answer choices since it is currently the most effective treatment)

Surgery-if all else fails or severe limitation due to involvement of joints.
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Quote:
Originally Posted by Novobiocin View Post
MTB 2 page 177 says---Triamcinolone may help

Bottomline: Try Triamcinolone initially (or collagenase if it is one of the answer choices since it is currently the most effective treatment)

Surgery-if all else fails or severe limitation due to involvement of joints.
mtb 3 says so/ sx is only definitive therapy/
yup, i wud pick steroids first...try it...prior to sx, indeed.
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