The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome
Background/Aim. Dupuytren’s disease is a progressive disease of the palmar and digital fascial structures, with functional limitations. There are no clear recommendations about the optimal time of surgical repair, concerning the hand impairment. The aim of our study was to investigate the r...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Military Health Department, Ministry of Defence, Serbia
2017-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600103S.pdf |
| Summary: | Background/Aim. Dupuytren’s disease is a progressive disease of the palmar
and digital fascial structures, with functional limitations. There are no
clear recommendations about the optimal time of surgical repair, concerning
the hand impairment. The aim of our study was to investigate the relation
between finger’s contracture degree and success of surgical treatment of the
Dupuytren's disease. Methods. This prospective analysis included 60 patients
operated on due to Dupuytren’s contracture. According to preoperative
contracture degree of proximal interphalangeal (PIP) and metacarpophalangeal
(MCP) joint, patients were divided into three groups: the group 1: < 15°, the
group 2: 15−30° and the group 3: > 30°. All the patients underwent operation
of partial palmar fasciectomy. Postoperative improvement was expressed with
contracture reduction INDEX. Results. There were 60 patients with 85 fingers
affected. The groups 1, 2 and 3 had 22 (37%), 37 (62%) and 26 (43%) fingers
with MCP contracture and 32 (37.4%), 24 (28.2%) and 29 (34.1%) fingers with
PIP contracture, respectively. Postoperative contractures of MCP joint in
these groups were 0, 0.135° and 5°, and of PIP joint 0, 2.08 ° and 16.89°,
respectively. After six months all MCP contractures resolved, while PIP joint
contracture in the group 3 remained 13.62°. The reduction INDEX was 98.85%,
97.62% and 75.52% in the groups 1, 2 and 3, respectively. There was a
statistically significant difference in the INDEX value between the groups (p
= 0.0001). Conclusion. The degree of PIP joint contracture is related to the
outcome of surgical treatment of Dupuytren’s disease. Optimal results are
achieved when contracture degree is between 15° and 30°. Surgical treatment
of MCP joint contracture is successful regardless of the preoperative joint
contracture degree. |
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| ISSN: | 0042-8450 2406-0720 |