Qu'est-ce que l'injection d'enzyme pour le cordon fascial palmaire : aperçu, avantages et résultats attendus

Résultats

Définition et aperçu

le palmar fascial cord is a type of connective tissue in the palm of the hand. If the cord is affected by a disorder, such as Dupuytren’s contracture, it thickens and causes the palm of the hand and one or more fingers to contract. The exact cause/s of the disorder is yet to be identified, but treatments are available for the condition. Dupuytren’s contracture is a disease that develops over a long period. It is characterised by the palm and fingers of the hand being slowly drawn inward. This is a direct result of the thickening connective tissue in the palm. Other symptoms of the disease differ from person to person. For example, it can be a painful condition to some people, while others may not even know they are affected, aside from noticing the visible symptoms of the condition. Doctors do not require complex tests to diagnose the condition. A simple physical examination of the hand and evaluating if the patient can place his or her hand flat on the table should be enough to diagnose Dupuytren’s contracture. The disease may develop over a long period of time, but it does so in stages. In the first stage, pain or discomfort can be felt in the palm and/or small and ring fingers of the hand. This stage is referred to as the proliferative phase. As the disease progresses into the involutional phase, the palmar fascial cord begins to tighten and becomes a bit noticeable. In the final stage, called the residual phase, the cord contracts resulting in the palm forming like a cupped hand. In this stage, the patient will find it difficult, if not impossible, to lay the hand flat on a table. Dupuytren’s contracture can be treated using a variety of methods. One method is to puncture the cord using a needle to release the contracture. The cord may contract again in the future, but the procedure can be repeated as needed. Another method is to perform surgery to remove the cord and tissue affected by the condition. The results are long lasting, but therapy is usually required after the procedure. One method that is gaining popularity is injecting the affected area with a collagenase enzyme called Clostridium histolyticum. The enzyme weakens the cord to a point where the doctor can break it and straighten the hand and finger/s.

Qui devrait subir et résultats attendus

Comme mentionné précédemment, la contracture de Dupuytren peut ou non causer de la douleur. Cependant, il y aura des signes clairs de la condition. Les patients qui constatent une déformation visible de la main et/ou du doigt sans cause apparente doivent consulter leur médecin. Le médecin présentera ensuite diverses options de traitement et recommandera une méthode particulière. Si le patient ne souhaite pas subir de chirurgie pour quelque raison que ce soit, l'injection de l'enzyme collagénase pourrait être la meilleure option. L'enzyme décomposera alors lentement le tissu conjonctif épaissi, le ramollissant dans le processus. En conséquence, le médecin devrait être en mesure de casser le tissu et de remettre le doigt dans son état normal. Cependant, les résultats peuvent ne pas être permanents. Si le cordon se resserre à nouveau, la procédure devra être répétée.

Comment fonctionne la procédure ?

Avant la procédure, le médecin doit d'abord diagnostiquer la maladie comme étant la maladie de Dupuytren. Le seul test généralement requis pour le diagnostic est un examen physique de la main. Le médecin peut également demander des informations sur l'état de santé actuel du patient, ses antécédents médicaux, le moment où les symptômes ont été remarqués pour la première fois et si l'état s'accompagne d'autres symptômes, tels que la douleur. Il y a quelques décennies, l'intervention chirurgicale était généralement la méthode de traitement recommandée. Cependant, le développement de l'enzyme collagénase a conduit à une procédure moins invasive. Si le patient accepte l'injection, l'enzyme sera injectée dans la paume de la main, précisément au niveau de la zone affectée. L'enzyme n'est pas injectée dans les doigts en raison des dommages qu'elle peut causer. Après la première injection, le patient devrait être en mesure de constater une amélioration. La procédure peut être répétée après une certaine période pour de meilleurs résultats.

Risques et complications possibles

Any medical procedure has associated risks and possibility of complications. In this procedure, adverse effects are common, but do not result in long-term damage or discomfort to the patient. Such adverse effects include pain, bleeding, and discomfort at the injection site. It is also possible for the patient to develop complications that are more serious, such as a ruptured tendon and a condition called complex regional pain syndrome. But serious complications rarely occur. Although injecting collagenase enzyme to treat the condition is considered highly effective, the results are not immediate. It may take some time for significant results to occur. During this time, the patient will need to avoid injuries to the hand. Patients should also be aware that the results might not be permanent. In time, the condition may reoccur or may even seem to worsen. When this happens, the procedure may be repeated or the doctor may recommend another treatment option, such as surgery.

Les références:

• Hindocha S, McGrouther DA, Bayat A. Évaluation épidémiologique des taux d'incidence et de prévalence de la maladie de Dupuytren en relation avec l'étiologie. Main (New York). 2009 septembre 4(3):256-69. [Medline]. [Texte intégral].
• Meathrel KE, Thoma A. Abducteur digiti minimi implication dans la contracture de Dupuytren du petit doigt. J Hand Surg Am. 2004 Mai. 29(3):510-3.

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**What is Injection⁤ of Enzyme for Palmar Fascial​ Cord: Overview, Benefits, ‌and Expected Results**



**Q: What is an ⁢Enzyme⁣ Injection for Palmar Fascial Cord?**



**A:**​ An enzyme injection for palmar fascial cord is an innovative treatment for chronic pain and inflammation caused by the palmar fascial cord, a thick band of‍ connective tissue that runs along the palm side of the ⁤hand. The injection involves using an enzyme called collagenase to break down and dissolve the taut and‍ thickened cord, thereby reducing pain and improving flexibility.



**Q:⁢ Who is a Candidate for the Treatment?**



**A:** Patients who suffer from chronic pain, stiffness, and tenderness in ​the palm⁢ or fingers caused by a⁣ tightened palmar fascial cord‍ are potential candidates for this treatment. It is often considered when conservative ​measures like rest, ⁤physical therapy, and pain medication have not provided significant relief.



**Q: How is the Procedure ⁣Performed?**



**A:**⁤ The procedure is performed in⁣ an outpatient setting. The area around the palmar fascia ‌is⁤ numbed‌ using local anesthesia. Under ultrasound guidance, the doctor injects collagenase directly into the⁤ cord.⁣ The injection typically‌ takes only a few minutes.



**Q: What are the Benefits of Enzyme Injection for Palmar Fascial Cord?**



**A:** Potential benefits of‍ the treatment include:



* **Pain Reduction:** The enzyme breaks down​ the taut cord, alleviating pain and discomfort.

* **Improved Flexibility:** Breaking down the fibrotic cord improves hand mobility and range of ​motion.

*​ **Non-Surgical Treatment:** This treatment offers an alternative to‌ invasive surgery, ⁣reducing recovery time and ⁢potential complications.



**Q: What are the Expected Results?**



**A:**​ Most patients experience a gradual reduction in ⁢pain and improvement in hand function ⁤within ⁤several weeks after the injection. However, results can vary among​ individuals, and some may require a ​second injection‌ for optimal outcomes.



**Q: What are the Potential ‍Risks or Side Effects?**



**A:** Minor side effects may include temporary discomfort, swelling,‌ or bruising‍ at ‍the injection site. Rarely, ‍allergic reactions or nerve damage can ⁤occur. Thorough consultation with your doctor will address any⁤ potential risks.



**Q: How Long Does the ⁢Improvement Last?**



**A:** The effects of the injection can last for several ⁤months to years. However, the long-term effectiveness may vary depending on the patient’s individual condition and activities. Additional‍ follow-up injections may be necessary if symptoms‌ return.



**Conclusion**



Enzyme​ injection for palmar fascial cord is a promising ‍treatment option for patients struggling with chronic pain and stiffness caused by⁢ a tightened palmar fascial cord. It offers ⁢significant ⁣benefits, including pain reduction, improved flexibility, and a non-surgical approach. By understanding the procedure, potential risks, and expected results, patients can‌ make an informed decision with⁤ their healthcare provider about whether this​ treatment ⁤is right for them.