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Objective: To evaluate the structural changes of arteries in palmar fascia and peculiarities of microhemodynamics in hand arteries of Dupuytren’s contracture (DC) patients. Materials and methods: A cross-sectional study that included patients with DC. The samples of pathologically changed palmar fascia which was excised operatively during partial fasciectomy (DC, n=49). Control group – histologic samples of normal palmar fascia from patients with open wounds (n=3). Depending on the number of layers of smooth muscle cells in media in transverse histologic sections, arteries divided into large (L), medium (M) and small (S) calibers and were measured using computed planimetry. 15 healthy volunteers (men aged between 40 and 67 years) and 10 patients with DC (men aged between 45 and 70 years) before the operation were recruited randomly to carry out the study of hemodynamics in superficial palmar arc and proper palmar digital arteries by pulsed ultrasound Doppler velocimetry (PUDVM). Results: In S-arteries the luminal diameter was decreased predominantly due to intimal thickening. In M-arteries besides intimal thickening, the outer diameter and muscular layer thickness increased. In L-arteries the outer and lumen diameters decreased, but intimal thickness also increased due to neo-intima formation. Retrograde blood flow, negative values of diastolic velocity, decrease of all calculated PUDVM values were observed in all DC patients. The most expressed decrease of values and indices was noted in zones affected with disease (proper palmar digital arteries for ring and small fingers and superficial palmar arc). Conclusion: Hemodynamic signs of vasoconstriction at the level of superficial palmar were in accordance with structural constrictive remodeling of perforating palmar fascia arteries, the severity of the last depended on the stage of Dupuytren’s contracture and arterial caliber. Correspondence to: Shchudlo N, DM, head of clinical and experimental laboratory for reconstructive and restorative microsurgery and hand surgery, Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics of the RF ministry of health, M. Ulianova street 6, 640014, Kurgan, Russia, Tel: 89225631752; E-mail: nshchudlo@mail.ru

rheumatology and orthopedic medicine

Arterial remodelling in palmar fascia and peculiarities of hand microhemodynamics in patients with dupuytren’s contracture-Arterial remodelling in dupuytren’s contracture