Pathogenesis of neuropathy in Dupuytren's contracture

Objective To review pathomorphological characteristics of the nerves of the palmar aponeurosis in Dupuytren’s contracture and develop a hypothesis of injury mechanisms. Material and methods The study included retrospective analysis of medical charts and surgical records of 123 patients with Dupuytren’s disease grades 2-4 who underwent partial aponeurectomy, light microscopic micrography of histological preparations of nerve trunks of palmar aponeurosis stained with hematoxylin and eosin. Results Three major types of nerve injury to palm aponeurosis were identified in Dupuytren’s disease including (1) active and residual perineuritis (41.6 %), (2) necrosis of endoneurial blood vessels and endoneurium (22%), and (3) fibromatosis of nerve sheath (37.4%). Higher rate of bilateral fascial fibromatosis and right-side involvement in unilateral fibromatosis (p