The prevalence of frozen shoulder in patients with limited Dupuytren disease.

Evidence from the literature suggests an association between Dupuytren disease and frozen shoulder syndrome, both clinically and histologically. An increased tendency for fibrotic healing after repetitive microtrauma could be an underlying mechanism. However, it remains unclear how strong this association is and if only mild signs of Dupuytren disease would also increase the risk of frozen shoulder. In 61 patients, we examined the hands for signs of Dupuytren disease and the shoulders for pain and limited motion. We found a 21,7% prevalence of frozen shoulder syndrome in patients with signs of Dupuytren disease versus 13,9% in those without. The other way around, in patients with frozen shoulder syndrome the prevalence of Dupuytren disease was 50% versus 36.7% in those without frozen shoulder syndrome. These differences were not statistically significant, contrary to similar research in the literature. However, methodological issues, especially the choice of control group, may explain the differences between our findings and previous studies. We conclude that the clinical association between Dupuytren disease may not be so strong as previously thought, especially in patients with only limited signs of the disease.

The Impact of Dupuytren Disease on Recovery of Motion at the Knee after Total Knee Arthroplasty.

Background: Arthrofibrosis is a complication of total knee arthroplasty (TKA) that can lead to poor outcome. Idiopathic arthrofibrosis and Dupuytren disease (DD) have similar histological appearance. The aim of this study is to determine the influence of DD on the recovery of motion after TKAy. Methods: Patients older than 50 who underwent a TKA for primary osteoarthritis were examined 1 year later for the presence of DD. They were divided into two groups based on the presence or absence of DD. The groups were compared to each other with regard to arc of motion (AOM) of the operated knee at 6 weeks and 1 year; the need for additional measures to improve the AOM, and the effect of obesity [body mass index (BMI) > 30]. Results: The study included 61 patients of which 25 (41%) had DD. There was no difference in AOM at 6 weeks or 1 year between the two groups. Patients in the DD group required a greater number of additional measures to improve AOM. Also, non-obese patients (BMI < 30) in the DD group had lower AOM at 1 year. Conclusions: Patients in the DD group needed additional physiotherapy or manipulation under anaesthesia (MUA) to achieve the same AOM. This might indicate a possible connection between DD and post-operative stiffness of the knee. Identifying patients with DD in the pre-operative period may help recognise patients who may have difficulty in regaining AOM after TKA. Level of Evidence: Level III (Therapeutic).

Pulley Rupture in Rock Climber after Collagenase Treatment for Dupuytren Contracture.

Pulley injuries and Dupuytren disease are quite common in rock climbing. We report a rock climber who was treated for a Dupuytren contracture with collagenase injection therapy. Two months later, he developed a traumatic pulley injury during climbing and was treated with a ring orthosis. However, the finger contracture deteriorated and both a recurrent pulley rupture and a second pulley rupture were diagnosed. We were unable to find any reports on the use of collagenase in rock climbers with Dupuytren disease. We report a case of pulley rupture in a rock climber, treated for Dupuytren contracture in the treated and an adjacent finger, 2 months after the injection of collagenase. Level of Evidence: Level V (Therapeutic).

Atraumatic Bucket Handle Abnormality of the Triangular Fibrocartilage Complex in an Adolescent.

Background Congenital abnormalities of the triangular fibrocartilage complex (TFCC) are rare and could be mistaken for a traumatic lesion. It is important to recognize these anatomical variations and to realize they do not always require treatment. Case Description An incidental finding of an atraumatic bucket handle abnormality of the TFCC in a 15-year-old male, who was treated arthroscopically for dorsal wrist pain. This structure was resected, thus obtaining a normal looking peripheral TFCC. Literature Review Literature regarding congenital abnormalities of the TFCC is limited to a meniscoid articular disc or a congenital perforation. To our knowledge, an atraumatic bucket handle abnormality has not been described yet. Clinical Relevance This congenital abnormality of the TFCC could be mistaken for a traumatic lesion on MRI, or during wrist arthroscopy; therefore, it is important to realize that this entity may occur and does not require treatment.