Moderate pressure for 10–20 seconds ruptures the cord.After the treatment with collagenase the person should use a night splint and perform digital flexion/extension exercises several times per day for 4 months.In February 2010 the US Food and Drug Administration (FDA) approved injectable collagenase extracted from Clostridium histolyticum for the treatment of Dupuytrens contracture in adults with a palpable Dupuytrens cord. (Three years later, it was approved as well for the treatment of the sometimes related Peyronies disease.) In 2011 its use for the treatment of Dupuytrens contracture was approved as well by the European Medicines Agency, and it received similar approval in Australia in 2013. However, the Swedish manufacturer abruptly withdrew distribution of this drug in Europe and the UK in March 2020 for commercial reasons. (It now is promoted primarily as a dermatological treatment for cellulite aka "cottage cheese thighs"). Collagenase is no longer available on the National Health System except as part of a small clinical trial. Radiation therapy
Radiation therapy has been used mostly for early-stage disease, but is unproven. Evidence to support its use as of 2017, however, was scarce —efforts to gather evidence are complicated due to a poor understanding of how the condition develops over time. It has only been looked at in early disease. The Royal College of Radiologists concluded that radiotherapy is effective in early stage disease which has progressed within the last 6 to 12 months. Alternative medicine
Several alternate therapies such as vitamin E treatment have been studied, though without control groups.
Causes
It is possible that facial clefts are caused by a disorder in the migration of neural crest cells.Another theory is that facial clefts are caused by failure of the fusion process and failure of inwards growth of the mesoderm. Other theories are that genetics play a part in the development of facial clefts or that they are caused by amniotic bands. Genetics
Overview
Around one in 700 individuals are born with craniofacial clefts. There are multiple genetic and environmental factors which contribute to craniofacial development. Within craniofacial disorders and abnormalities, orofacial clefts, and specifically cleft lip (CL) and cleft palate (CP) are the most common in humans. Occurrences of CL/P are most often (around seventy percent of cases) isolated and nonsyndromic, meaning they are not associated with a syndrome or inherited genetic conditions. Around thirty percent occur with other structural variances, and over 500 syndromes have been identified in which clefting is a principal feature. Clefting can result from teratogens, an agent that disrupts embryo development such as, radiation, maternal infection, chemicals, or drugs. Chromosomal abnormalities or mutations at single gene loci have also contributed to clefting development. Genetic causes are linked with most craniofacial syndromes, and CL/P and other orofacial clefts are recognized as heterogeneous disorders, meaning there are multiple recognized causes. Orofacial clefts have great phenotypic diversity, and their associated genetic environments have called for vast research and investigation.