Dupuytren’s Contracture: Epidemiological Patterns and Results Following Radical Fasciectomy
Introduction: Dupuytren’s disease is a debilitating condition, affecting the palmar fascia of the hand. Patients develop a flexion contracture and have difficulties in activities of daily living. Treatment is usually surgical, and a wide range of options are available. Aim: To study the epidemi...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2018-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/12359/37124_CE[Ra1]_F(SL)_PF1(AGAK)_PFA(AK)_PB(AG_KM)_PN(SL).pdf |
| Summary: | Introduction: Dupuytren’s disease is a debilitating condition,
affecting the palmar fascia of the hand. Patients develop a
flexion contracture and have difficulties in activities of daily
living. Treatment is usually surgical, and a wide range of options
are available.
Aim: To study the epidemiological parameters associated with
Dupuytren’s contracture and to study the results following
Radical Fasciectomy.
Materials and Methods: This was a prospective, interventional,
institutional based study conducted at Dr RML Institute of
Medical Sciences. A total of 26 patients with Dupuytren’s
disease, fulfilling the inclusion criteria, were treated with radical
fasciectomy. Epidemiological parameters and postoperative
improvement in form of Digitopalmer Distance (DPD), extension
lag and Quick DASH scores were recorded. Data was analysed
using SPSS version 21 software. Continuous data was analysed
by student's t-test and categorical data was analysed by chisquare test and p-value less than 0.05 was considered as
significant.
Results: Mean age of involvement in the present study was
54.82±7.34 years. An 84% (22 patients) of patients were male
and 16% (4 patients) female. Bilateral hand involvement was
seen in 84.61% and single hand involvement was seen in
15.38%. Dominant hand involvement was seen in 69.23% cases,
nondominant hand in 15.38% cases and bilateral hands equally in
15.38% cases. Thenar Band and Commissural Band was noticed
in 19% of cases. A total of 27% of all cases were diabetics, and
15% were known smokers. One patient in the entire series was
a known epileptic on medications. DPD following surgery at two
weeks and three months postoperatively was satisfactory as
more than 60% of patients had full closure and more than 90%
had a DPD of less than two centimeters. Extension Lag at MCP
and PIP joints was found to be satisfactory as full opening at
both MCP and PIP joints was found in more than 80% patients
postoperatively at two weeks and three months.
Conclusion: Outcomes following radical fasciectomy are very
encouraging in terms of functional results as well as patient
satisfaction. Intensive hand therapy during the first two weeks
in the postoperative period gives best functional results. |
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| ISSN: | 2249-782X 0973-709X |