Advertisement
Original Communications| Volume 25, ISSUE 6, P1157-1162, November 2000

The injection of nodules of Dupuytren's disease with triamcinolone acetonide

      Abstract

      Over a 4-year period 63 patients (75 hands) with Dupuytren's nodules were treated with a series of injections with the steroid triamcinolone acetonide directly into the area of disease. The purpose of this study was to determine whether intralesional injections of triamcinolone acetonide could produce softening and flattening in nodules of Dupuytren's disease as seen in the intralesional injections of hypertrophic scars and keloids. After an average of 3.2 injections per nodule 97% of the hands showed regression of disease as exhibited by a softening or flattening of the nodule(s). Although some patients had complete resolution of the nodules, most experienced definite but incomplete resolution of the nodules in the range of 60% to 80%. Although a few patients did not experience recurrence or reactivation of the disease in the injected nodules or development of new nodules, 50% of patients did experience reactivation of disease in the nodules 1 to 3 years after the last injection, necessitating 1 or more injections. The findings of this study indicate that the intralesional injection of nodules of Dupuytren's disease with triamcinolone acetonide may modify the progression of the disease. (J Hand Surg 2000;25A:1157-1162. Copyright © 2000 by the American Society for Surgery of the Hand.)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ketchum LD
        • Smith J
        • Robinson DW
        • Masters FW.
        The treatment of hypertrophic scar, keloid and scar contracture by triamcinolone acetonide.
        Plast Reconstr Surg. 1966; 38: 209-218
        • Ketchum LD
        • Robinson DW
        • Masters FW.
        The degradation of mature collagen: a laboratory study.
        Plast Reconstr Surg. 1967; 40: 89-91
        • Rayan GM.
        Clinical presentation and types of Dupuytren's disease.
        Hand Clin. 1999; 15: 87-96
        • Badalamente MA
        • Hurst LC.
        The biochemistry of Dupuytren's disease.
        Hand Clin. 1999; 15: 35-42
        • Houck JC
        • Patel YM.
        Proposed mode of action of cortico-steroids on the connective tissue.
        Nature. 1965; 206: 158-160
        • Ketchum LD.
        Effects of triamcinolone on tendon healing and function: a laboratory study.
        Plast Reconstr Surg. 1971; 47: 471-482
        • Hurst LC
        • Badalamente MA.
        Nonoperative treatment of Dupuytren's disease.
        Hand Clin. 1999; 15: 97-107
        • Hueston JT
        The Dupuytren's diathesis.
        in: Dupuytren's contracture. E & S Livingstone, Edinburgh1963: 51-63
        • McFarlane RM.
        The current status of Dupuytren's disease.
        J Hand Surg. 1983; 8: 703-708