Travmatologiâ i Ortopediâ Rossii (Jun 2022)
Pathomorphological Changes in Vater-Pacinian Corpuscles in Palmar Fascial Fibromatosis Depending on the Dupuytren’s Contracture Degree
Abstract
Background. World literature data indicate the involvement of Vater-Pacinian corpuscles in the pathogenesis of palmar fascial fibromatosis, but the information about their pathomorphological changes and histomorphometric characteristics is contradictory. Purpose a comparative analysis of qualitative and quantitative changes in Vater-Pacinian corpuscles in patients with Dupuytrens contracture of varying degrees. Methods. The analysis of case histories and material resected during operations from 100 patients with Dupuytrens contracture, was made. The patients were divided into two groups: group 1 those with degree I-II contracture (n = 31), group 2 those with degree III-IV (n = 69). Histomorphometry of 122 Vater-Pacinian corpuscles, in which the cut plane passed through the central nucleus, was performed in paraffin and semi-thin sections of the patients surgical material. Results. At the time of the disease onset, the difference in age medians in the groups was not statistically significant. The age median at the time of surgery (group 1 56.0 years; group 2 61.0 years, p = 0.001) and the median of the disease duration (group 1 5.0 years; group 2 9.0 years, р = 0.006) were higher in group 2, the variability in the disease duration was comparable. As it has been established, Vater-Pacinian corpuscles undergo successive reactive-destructive changes in the form of death of the central axon, stratification of the capsule, inflammation, fibrosis, deformation and destruction. The number of corpuscles is greater (р = 0.040) in group 1 1 (0; 3) than in group 2 0 (0; 6). In group 2, the corpuscles have larger diameters (group 1 0.85 mm; group 2 0.96 mm, p = 0.072), more layers of the outer capsule (group 1 17; group 2 20, p = 0.032). Conclusions. In patients with Dupuytrens contracture, along with compensatory and adaptive changes in Vater-Pacinian corpuscles (hyperplasia and hypertrophy), their irreversible destructive changes develop, which, when the disease progresses to grade 3-4, lead to a loss in the number of bodies.
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