Dupuytren Disease

Chapter 20 of Volume 1, Hand & Upper Limb. Revision notes and examiner-style viva questions with model answers for the FRCS (Plast).

22 viva questions in this chapter

1. You are shown a photograph of a hand. How would you proceed?
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2. Describe the anatomy of the palmar fascia and its relevance to this disease.
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3. What is a spiral cord and why does it matter?
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4. What is happening in the tissue?
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5. What is the natural history?
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6. What are your indications for intervention?
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7. What is Dupuytren diathesis and why do you care?
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8. What are his options?
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9. Take me through a limited fasciectomy.
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10. You have excised the fascia and the PIP joint still will not extend. What now?
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11. Tell me about external fixation for severe PIP contractures.
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12. Is it any better than simply releasing the joint?
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13. He has recurred two years after a fasciectomy. What now?
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14. What are the complications and how do you consent for them?
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15. How do you know the PIP contracture is from the cord and not from the joint?
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16. What is driving the myofibroblast proliferation?
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17. The finger is still white after tourniquet release. Talk me through it.
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18. You divide a digital nerve during the dissection. What do you do?
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19. Your trainee has done a dermofasciectomy, released the A2 pulley, and there is exposed flexor tendon. What now?
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20. The digit has skin flap necrosis in dressings clinic. How do you manage it?
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21. Six weeks post-operatively he has pain, swelling and stiffness out of proportion. What is going on and what do you do?
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22. You have repaired the digital nerve. What happens next, biologically?
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