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    1949 King PDF

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    eveli1na18497
    1) A claim was made that high doses of vitamin E therapy could successfully treat Dupuytren's contracture by causing thickening of the fascia to disappear and relieving finger contracture. 2) A study of 13 patients who received high doses of vitamin E found no evidence that it improved contractures. 4 patients reported side effects that caused them to stop treatment. 3) In only 1 patient was there a possible slight improvement, but follow up showed the contracture remained moderate after treatment stopped. The vitamin E therapy was found to be ineffective and was abandoned.

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    1949 King PDF

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    1) A claim was made that high doses of vitamin E therapy could successfully treat Dupuytren's contracture by causing thickening of the fascia to disappear and relieving finger contracture. 2) A study of 13 patients who received high doses of vitamin E found no evidence that it improved contractures. 4 patients reported side effects that caused them to stop treatment. 3) In only 1 patient was there a possible slight improvement, but follow up showed the contracture remained moderate after treatment stopped. The vitamin E therapy was found to be ineffective and was abandoned.

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    1) A claim was made that high doses of vitamin E therapy could successfully treat Dupuytren's contracture by causing thickening of the fascia to disappear and relieving finger contracture. 2) A study of 13 patients who received high doses of vitamin E found no evidence that it improved contractures. 4 patients reported side effects that caused them to stop treatment. 3) In only 1 patient was there a possible slight improvement, but follow up showed the contracture remained moderate after treatment stopped. The vitamin E therapy was found to be ineffective and was abandoned.

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    56 views1 page

    1949 King PDF

    Uploaded by

    eveli1na18497
    1) A claim was made that high doses of vitamin E therapy could successfully treat Dupuytren's contracture by causing thickening of the fascia to disappear and relieving finger contracture. 2) A study of 13 patients who received high doses of vitamin E found no evidence that it improved contractures. 4 patients reported side effects that caused them to stop treatment. 3) In only 1 patient was there a possible slight improvement, but follow up showed the contracture remained moderate after treatment stopped. The vitamin E therapy was found to be ineffective and was abandoned.

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    VITAMIN E THERAPY IN DUPUYTREN'S CONTRACTURE

    E x a m i n a t i o n of the C l a i m t h a t V i t a m i n T h e r a p y i s S u c c e s s f u l

    RAYMOND A. K I N G , LONDON, ENGLAND

    From the Orthopaedic and Accident Department, The London Hospital

    I t has been claimed t h a t s t r i k i n g success can be gained i n the t r e a t m e n t of D u p u y t r e n ' s


    c o n t r a c t u r e of the palmar fascia b y simple oral a d m i n i s t r a t i o n of v i t a m i n E i n h i g h dosage.
    I t has been said t h a t , after such t r e a t m e n t , t h i c k e n i n g of the fascia disappears a n d
    contracture of t h e fingers is relieved. Le R o y Steinberg (1947) used d a i l y doses of 300 m g .
    of m i x e d n a t u r a l tocopherols (of w h i c h 60 per cent, is i n the f o r m of alpha-tocopherol) for a
    few weeks u n t i l m a x i m a l effect was gained. A d a i l y maintenance dose of 1 m g . per k i l o of
    b o d y weight was continued thereafter.
    Such a claim of success f r o m so simple a t r e a t m e n t w a r r a n t e d careful investigation and
    a t r i a l series of t h i r t e e n patients was studied i n the Orthopaedic a n d Accident D e p a r t m e n t
    of the L o n d o n H o s p i t a l . The routine dosage was 100 m g . of pure synthetic alpha-tocopherol,
    three times a day, given i n the f o r m of Roche " E p h y n a l F o r t e " 20 m g . tablets. The a i m
    was t o continue t r e a t m e n t for about three weeks, or " u n t i l m a x i m a l i m p r o v e m e n t h a d been
    g a i n e d , " a n d thereafter t o give a smaller maintenance dose. I n seven patients we succeeded
    i n g i v i n g heavy doses for periods ranging f r o m four t o eight weeks; i n four the t r e a t m e n t
    was abandoned d u r i n g the t h i r d week; and i n t w o i t was abandoned d u r i n g the first few days.
    F o u r patients complained of headache, nausea, fatigue, drowsiness, " singing-in-the-ears,"
    " swelling of the t o n g u e , " giddiness, b l u r r e d vision, sweating, a n d other symptoms t h a t made
    i t impossible t o continue. The other nine patients made no such complaints, and four of
    t h e m w ere q u i t e sure t h a t t h e y h a d gained i m p r o v e m e n t . One, w i t h a moderate degree of
    r

    contracture, said: " the band feels softer." A n o t h e r , w i t h d e f o r m i t y of moderate degree, said:
    " the fingers feel straighter and the aching p a i n has gone." T w o others h a d severe d e f o r m i t y
    a n d b o t h insisted t h a t " there is i m p r o v e m e n t " b u t were unable t o specify the nature of the
    improvement.
    The effects were checked i n every case b y detailed clinical records, accurate measurement
    of d e f o r m i t y , a n d serial clinical photographs. I n twelve of the t h i r t e e n patients there was
    no evidence whatever of any a l t e r a t i o n . I n one, w i t h moderate d e f o r m i t y , we t h i n k t h a t
    after the second week of t r e a t m e n t the finger was somewhat straighter and the p a l m a r
    t h i c k e n i n g somewhat softer. Review one year later (after five weeks of f u l l dosage a n d three
    weeks of maintenance dosage) shows t h a t he s t i l l has moderate d e f o r m i t y . I n the other
    t w e l v e , i n c l u d i n g those t r e a t e d on f u l l dosage for six t o eight weeks (at a cost of £5 a week),
    we can see no change. The t r e a t m e n t has been abandoned.

    REFERENCE

    STEINBERG, C. L E R O Y ( 1 9 4 7 ) : " Fibrositis, including Dupuytren's Contracture—A New M e t h o d of


    Treatment." N e w Y o r k S t a t e J o u r n a l of M e d i c i n e , 4 7 , 1 6 7 9 .

    VOL. 31 B, NO. 3, AUGUST 1949 443

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