THE PALMAR FASCIA AFTER TREATMENT BY THE CONTINUOUS EXTENSION TECHNIQUE FOR DUPUYTRENS CONTRACTURE

After complete elongation using the continuous extension technique the palmar fascia of four patients with Dupuytren's contracture was exami ned by light and electron microscopy and compared with non-elongated s amples from 20 patients at the same clinical stage of the disease. Nod ules and cords were no longer clinically recognizable after extension. The tissue contained collagen fibrils of uniform diameter (about 50 n m), densely packed in fibres parallel to the stretching force. Fine fi laments (presumably proteoglycans) formed a network which was intermin gled with and periodically bound to the collagen fibrils. Fibroblasts and myofibroblasts with an high biosynthetic activity and oxytalan-lik e microfibrils were aligned along the collagen fibres. The results sho w that in Dupuytren's disease the contracted palmar fascia reacts to e xternal forces with neoformation and reorientation of all tissue compo nents by myofibroblasts.