THE CONTINUOUS ELONGATION TECHNIQUE FOR SEVERE DUPUYTRENS DISEASE - A BIOCHEMICAL-MECHANISM

被引：51

作者：

BAILEY, AJ

TARLTON, JF

VANDERSTAPPEN, J

SIMS, TJ

MESSINA, A

机构：

[1] Muscle and Collagen Research Group, Department of Veterinary Medicine, University of Bristol, Langford, Bristol

[2] Hand Surgery Centre, Traumatologic and Orthopaedic Hospital, Torino

来源：

JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME | 1994年 / 19B卷 / 04期

关键词：

D O I：

10.1016/0266-7681(94)90220-8

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Continuous extension of Dupuytren's contracture prior to fasciectomy results in a softening of the tissue, allowing straightening of the fingers. The observed change in cross-link profile indicates an increase in newly synthesised collagen due to increased turnover. This was confirmed by demonstration of the increases in levels of the degradative enzymes, the neutral metalloproteinases, collagenase and gelatinase and the acidic cathepsins B and L. Both types of enzyme effectively depolymerize the collagen fibres, albeit by different mechanisms, leading initially to loss of tensile strength and ultimately to solubilization. We suggest that the increase in enzyme activity is generated by tension on the fibroblasts of this metabolically active tissue produced during the continuous extension of the retracted fingers. The weakening of the fibres by degradation and the increase in newly synthezised collagen provide an explanation for the extension of the tissue without trauma.

引用

页码：522 / 527

页数：6

共 15 条

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