Abstract
Dupuytren’s disease is a hereditary condition leading to progressive fibrosis in the palm of the hand, causing gradual contracture of the digits and significant functional impairment. Various treatments are available and are more or less invasive. Nevertheless, no treatment has shown full efficiency with regard to skin invasion by fibrosis as well as recurrences. Fat tissue grafting is well-known in the field of plastic surgery, namely for the positive effect on fibrotic and scar tissues. Fat grafting is also a source of adipose-derived stem cells that are known to inhibit myofibroblastic activity in vitro. Myofibroblasts are also incriminated in the formation of the fibrous cords. In this chapter, we consider associating fat grafting to the techniques of aponeurotomy and aponeurectomy, in the hope of improving scar outcomes as well as reducing recurrences.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Nordenskjöld J, Englund M, Zhou C, Atroshi I. Prevalence and incidence of doctor-diagnosed Dupuytren’s disease: a population-based study. J Hand Surg Eur Vol. 2017;42(7):673–7.
Geoghegan JM, Forbes J, Clark DI, Smith C, Hubbard R. Dupuytren’s disease risk factors. J Hand Surg. 2004;29(5):423–6.
Luck JV. Dupuytren’s contracture; a new concept of the pathogenesis correlated with surgical management. J Bone Joint Surg Am. 1959;41-A(4):635–64.
Tubiana R, Michon J, Thomine J. Scheme for the assessment of deformities in Dupuytren’s disease. Surg Clin North Am. 1968;48(5):979–84.
Hurst LC, Badalamente MA, Hentz VR, Hotchkiss RN, Kaplan FTD, Meals RA, et al. Injectable collagenase clostridium histolyticum for Dupuytren’s contracture. N Engl J Med. 2009;361(10):968–79.
Eaton C. Evidence-based medicine: Dupuytren contracture. Plast Reconstr Surg. 2014;133(5):1241–51.
Henry M. Dupuytren’s disease: current state of the art. Hand (N Y). 2014;9(1):1–8.
Alfonso-Rodríguez C-A, Garzón I, Garrido-Gómez J, Oliveira A-C-X, Martín-Piedra M-Á, Scionti G, et al. Identification of histological patterns in clinically affected and unaffected palm regions in Dupuytren’s disease. PLoS One. 2014;9(11):e112457.
Brazzelli M, Cruickshank M, Tassie E, McNamee P, Robertson C, Elders A, et al. Collagenase clostridium histolyticum for the treatment of Dupuytren’s contracture: systematic review and economic evaluation. Health Technol Assess Winch Engl. 2015;19(90):1–202.
van Rissjen A, ter Linden H, Werker P. Five-year results of a randomized clinical trial on treatment in Dupuytren’s disease: percutaneous needle fasciotomy versus limited fasciectomy. Plast Reconstr Surg. 2012;129(2):469–77.
Hueston J. “Firebreak” grafts in Dupuytren’s contracture. Aust N Z J Surg. 1984;54(3):277–81.
Verhoekx JSN, Mudera V, Walbeehm ET, Hovius SER. Adipose-derived stem cells inhibit the contractile myofibroblast in Dupuytren’s disease. Plast Reconstr Surg. 2013;132(5):1139–48.
Hovius SER, Kan HJ, Smit X, Selles RW, Cardoso E, Khouri RK. Extensive percutaneous aponeurotomy and lipografting: a new treatment for Dupuytren disease. Plast Reconstr Surg. 2011;128(1):221–8.
Hovius SER, Kan HJ, Verhoekx JSN, Khouri RK. Percutaneous aponeurotomy and lipofilling (PALF): a regenerative approach to Dupuytren contracture. Clin Plast Surg. 2015;42(3):375–81, ix.
Engstrand C, Krevers B, Nylander G, Kvist J. Hand function and quality of life before and after fasciectomy for Dupuytren contracture. J Hand Surg. 2014;39(7):1333–1343.e2.
Pallua N, Baroncini A, Alharbi Z, Stromps JP. Improvement of facial scar appearance and microcirculation by autologous lipofilling. J Plast Reconstr Aesthet Surg. 2014;67(8):1033–7.
Khouri RK, Smit JM, Cardoso E, Pallua N, Lantieri L, Mathijssen IMJ, et al. Percutaneous aponeurotomy and lipofilling: a regenerative alternative to flap reconstruction? Plast Reconstr Surg. 2013;132(5):1280–90.
Otayek S, Pierrart J, Masmejean EH. Dupuytren’s disease and needle aponeurotomy: rupture of a deep common flexor tendon: a case report and literature review. J Orthop Case Rep. 2016;6(3):88–90.
Zhou C, Ceyisakar IE, Hovius SER, Feitz R, Slijper HP, Lingsma HF, et al. Surgeon volume and the outcomes of Dupuytren’s surgery: results from a Dutch multicenter study. Plast Reconstr Surg. 2018;142(1):125–34.
Citron ND, Nunez V. Recurrence after surgery for Dupuytren’s disease: a randomized trial of two skin incisions. J Hand Surg Edinb Scotl. 2005;30(6):563–6.
Eberlin KR, Mudgal CS. Complications of treatment for Dupuytren disease. Hand Clin. 2018;34(3):387–94.
Dias JJ, Aziz S. Fasciectomy for Dupuytren contracture. Hand Clin. 2018;34(3):351–66.
Kan HJ, Verrijp FW, Hovius SER, van Nieuwenhoven CA, Dupuytren Delphi Group, Selles RW. Correction: recurrence of Dupuytren’s contracture: A consensus-based definition. PLoS One. 2019;14(4):e0216313.
Selles RW, Zhou C, Kan HJ, Wouters RM, van Nieuwenhoven CA, Hovius SER. Percutaneous aponeurotomy and lipofilling versus limited fasciectomy for Dupuytren’s contracture: 5-year results from a randomized clinical trial. Plast Reconstr Surg. 2018;142(6):1523–31.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
1 Electronic Supplementary Materials
Video 108.1
Superposition of both superficial and deep anatomical planes involved in DD surgery (M4V 8141 kb)
Video 108.2
Microfat grafting in Dupuytren’s contracture (M4V 5476 kb)
Video 108.3
The syringe of fat_Part 1 (M4V 41839 kb)
Video 108.4
The syringe of fat_Part 2 (M4V 40664 kb)
Video 108.5
The syringe of fat_Part 3 (M4V 39466 kb)
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Sawaya, E.T., Yerganyan, V.V., Bastien, J., Alet, JM. (2022). Microfat Grafting in Dupuytren’s Contracture: From Hypodermis Reconstruction and Scar Optimization to Recurrence Prevention. In: Kalaaji, A. (eds) Plastic and Aesthetic Regenerative Surgery and Fat Grafting. Springer, Cham. https://doi.org/10.1007/978-3-030-77455-4_108
Download citation
DOI: https://doi.org/10.1007/978-3-030-77455-4_108
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-77454-7
Online ISBN: 978-3-030-77455-4
eBook Packages: MedicineMedicine (R0)