Welcome
Welcome to Dupuytrens.co.uk. This site aims to be the one stop website for British Dupuytrens information. Please feel free to look around and contact us if you want more information.Collagenase Update
I have been pretty heavily involved in Collagenase for the last few years. I started as an investigator for the UK on the Phase 3 trials and then moved to helping Pfizer with research into Dupuytrens and helping with the European instructional brochure. It has been a fascinating journey seeing how a big pharmaceutical company approaches something like this. I had the pleasure in the Autumn to be invited to take part in the filming of the instructional video down in London and this will now be used to teach all hand surgeons across Europe about Collagenase and how to use it.Collagenase is now licensed. See here for more details
Finally after 5 years of waiting we are there. Collagenase is now fully available in Derby for Private patients.The local primary care Trust (PCT) has decided at first review that it is too expensive compared to Needle Aponeurotomy but we will keep plugging away at this and see what happens.
What is Dupuytrens?
• Dupuytrens is a condition characterised by fibrosis of the palmar aponeurosis leading to contracture of the fingers- Surgery has been the standard treatment for many years but realisation that the results of surgery are not as good for the patient as many of us have thought has lead to an increasing interest in alternative treatments both medical and non medical. Here we will try to give you the lowdown on all the treatments available and tell you if they are safe or not.
- If you want surgery or another form of treatment, we can direct you to the relevant local person or arrange treatment for you at our clinic in Derby.
The good news is that Dupuytren's Disease is treatable! The bad news is that it is not curable at the moment. I prefer to talk in terms of controlling Dupuytrens. Every patient with Dupuytren’s will experience recurrence after treatment or extension into another area of the hand. If you are lucky and have a mild form of the problem this might not be for 20 years. For some people this might be very rapid - 6 months. There are a large number of treatments available for Dupuytren’s which have developed over time. These range from the legendary (letting a bishop kick your hand) to the barmy. Most techniques today depend on some form of surgical intervention allied to splintage which may slow down the rate of recurrence although we have no evidence to support such a view and increasingly i do not use splints! Surgical techniques have ranged from simply cutting the band in the palm, originally described by Sir Astley Cline to major surgical interventions, removing significant amounts of the diseased skin and replacing it with skin grafts. Like most areas of surgery interest is slowly increasing in less interventional techniques such as Needle Aponeurotomy and Collagenase. Like any other form of surgery you should check how often your surgeon carries out the planned operation and the possible complications. For Dupuytren’s surgery I would have no hesitation in stating that your surgeon should be a specialist in Hand Surgery. This is not the place for a general Orthopaedic or Plastic Surgeon, your hand is too important. To find a surgeon you can look on the British Society for Surgery of the Hand website, the Society do not offer any guarantee of ability but all members have expressed an interest in Hand Surgery and carry out a substantial amount in their NHS practise. All surgeons in the UK carry out fasciectomy in one of its forms but very few carry out NA. There are now a few surgeons performing Needle Aponeurotomy in the UK but I think we have done more in Derby than anywhere else in the UK. Radiotherapy is carried out in Europe for Dupuytrens disease and the National Institute of Clinical Effectiveness have accepted its use in the UK.