Handling a disease such as Dupuytren's contracture is quite a challenge, mainly because nothing is written in stone. We can counter almost any argument and find a flaw in almost any type of treatment. But still, doctors have numerous successes with their patients, especially when they are diagnosed and treated at an early stage.
But what is the current trend about Dupuytren's disease treatment? Giving an individual answer is difficult due to the high number of doctors with different opinions and available options. But we can look at various European countries and evaluate the most common treatment, opinions, and practices.
Collagenase and surgical treatments for Dupuytren's disease are widespread across the globe. Naturally, they are mostly used in their own native countries. For example, the United States is perhaps the country that most frequently uses collagenase treatment. The pharmacological companies that gave rise to this injection are found in North America. They also make a lot of money selling collagenase injections as the ultimate treatment—no wonder why they usually lead the research in this particular field.
Not many countries follow the same line as the United States because the collagenase treatment is expensive and not easy to implement. However, Scandinavia is one of those countries with enough money to buy and use this alternative to surgical procedures.
On the other hand, there are many types of surgery for Dupuytren's disease. Two of them are needle fasciotomy and dermofasciectomy. Some countries like France have professionals constantly disputing with one another about which one is the best. In this particular country, it is common to see rheumatologists performing the former and hand surgeons performing the latter. They rarely use collagenase injections.
There are many countries and different perspectives of the same disease in Europe. Surgery and collagenase treatments may seem the best treatment for some, but countries like Germany and the Netherlands are willing to try other alternatives.
In Germany, Dupuytren's disease is often treated with a dose of radiotherapy, which helps improve the outcome and manage the symptoms. In the Netherlands, they use a completely different method and have a lipofilling technique to treat Dupuytren's contracture. They also hold many congresses and successful events about the disease.
As you can see, there are many approaches and different techniques to treat Dupuytren's disease throughout the globe. Not having a single opinion is perhaps the consequence of not having comparative studies in some cases, and not reaching an agreement in others. But luckily for patients, the majority of doctors share good experiences and successes in congresses and special events.
As more evidence is gathered and more clinical experience is translated into guidelines, we may have a specific algorithm to treat Dupuytren's disease in the future. But for now, we can rest assured that the right combination of skill and medical experience is usually enough to get the best results from a variety of techniques and approaches.
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