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D upuytren's disease (DD), also known as palmar fibromatosis, is a proliferative fibroplasia of palmar aponeurosis. The condition is a major cause of morbidity and causes progressive and irreversible flexion contractures in the fingers, which in turn affects patients' daily activities and reduces their quality of life. Although the etiology of DD is unknown, it has been shown to originate from an autosomal dominant inheritance with incomplete penetrance. [1] Diabetes mellitus, long-term use of anticonvulsants due to epilepsy, liver disease, HIV infection, complex regional pain syndrome, myocardial infarction, alcohol consumption and/or smoking, and trauma are the risk factors for DD. The disease is clinically categorized into early, active, and advanced stages. In the early stage, the integrity of the skin is compromised. Nodules and cords are seen during the active stage. In the advanced stage, fibrocytes and contracture develop. [2][3][4] Objectives: We investigated the use of extracorporeal shock wave therapy (ESWT) in patients with Dupuytren's Disease (DD) palmar nodules in an attempt to reduce the contracture, alleviate the pain (if any), increase the range of motion and quality of life, and delay a probable surgery in the long term. Methods: Patients with DD who presented to our hand surgery clinic and fulfilled the inclusion criteria were enrolled. The treatment was performed by the same physician using the ESWT device once a week for six weeks. The patients were evaluated with the VAS score, Quick-DASH questionnaire, and MAYO wrist score, and their grip strength was measured using a Jamar dynamometer. Results:The mean age of the 23 patients included in the study was 51 years. There was a significant improvement in the second measurement of VAS and DASH scores compared with the preoperative values. The increase in the second and final follow-up measurements of the MAYO score and grip strength results compared with the preoperative values was found significant. The table-top test results turned negative in 16 patients. Conclusion:We can suggest that ESWT in the early term can be preferred over costly injections and surgical intervention options as it increases the quality of life and delays the recurrence of contractures.

Background: The objective of this study was to evaluate the efficacy of subacromial injections of collagenase and corticosteroid in rats with experimentally induced adhesive capsulitis. Method: Thirty adult Wistar albino male rats were distributed into 3 groups of 10 rats each after stabilization of their shoulders for 3 weeks: the first group received a single dose of 0.002 mg (0.25 mL) subacromial collagenase; the second group received a single dose of 1.60 mg (0.25 mL) subacromial steroid, and the third group received a single dose of 0.25 mL subacromial saline solution. One week later, we investigated shoulder range of motions, collagen content of the shoulder, and joint cartilage structure. Results: There was no statistically significant difference in the cartilage damage between the groups (p > 0.05). Fibrosis measurements were significantly lower in the collagenase group than in the steroid and saline groups. There was no significant difference in fibrosis between the steroid and saline groups (p > 0.05). Abduction measurements were significantly higher in the collagenase group than in the steroid and saline groups (p < 0.001). No significant difference in the abduction measurements was observed between the saline and steroid groups (p > 0.05). Conclusion: We observed that subacromial injections of collagenase Clostridium histolyticum effectively treated adhesive capsulitis. The results suggest that this treatment could be considered for use in patients with an intact rotator cuff.

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Introduction ACTS secondary to amyloidosis is a very rare situation in the literature, and here, we present a unique case of ACTS secondary to amyloidosis. Case Report A 61-year-old male patient was admitted to our hospital with complaints of numbness in the lateral half of his 1, 2, 3, and 4 fingers of his right hand. These complaints started acutely, and the patient did not have a history of trauma. His clinical examination was suitable for acute carpal tunnel syndrome. Discussion Carpal tunnel syndrome, as well as acute carpal tunnel syndrome, may occur based on different causes. ACTS is very rare, especially when it is not caused by a trauma. Here, we presented a unique case of ACTS based on amyloidosis. Conclusion It should be kept in mind when ACTS may occur in patients with the diagnosis of amyloidosis.