The Journal of Bone and Joint Surgery, Vol 62, Issue 3 425-432, Copyright © 1980 by Journal of Bone and Joint Surgery, Inc
Dupuytren's contracture. An electron microscopic, biochemical, and clinical correlative study
RH Gelberman, D Amiel, RM Rudolph and RM Vance
Fascial specimens were obtained from twenty-four patients treated
operatively for Dupuytren's contracture. The nodules and cords were
examined by electron microscopic and biochemical techniques. The clinical
course and response to operative treatment were then correlated with the
tissue findings. Electron microscopic analysis revealed myofibroblasts in
the nodules of seven of twenty-four patients. Fibroblasts containing
prominent microtubules were found in ten patients. The fascia contained
type-III collagen, increased amounts of collagen per unit of dry weight,
and an increase in reducible cross-links of collagen. While the nodules
were noted to contain a greater increase in reducible cross-links than the
cords, there was little variation in the biochemical findings from patient
to patient. Clinical recurrence was not related to the age of the patient
at onset, duration, or severity of disease. Recurrence was related to the
electron microscopic findings of myofibroblasts in the nodules and
fibroblasts containing prominent microtubules in the fascia of these
patients.
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