Early and Long-Term Results Following Surgery for Dupuytren's Disease
Languages of publication
The aim of the study was assessment of the early and long-term results following surgery for Dupuytren's disease.Material and methods. In this study the treatment results of 74 patients with Dupuytren's disease were revealed. Patients were treated using fasciotomy, selective fasciectomy, subtotal fasciecotmy and dermofasciectomy. Patients were divided into two groups. Group I (n=35) was examined prospectively 3 times: prior to the surgery, 1 and 3 months after it. Group II (n=39) was examined retrospectively once between 3 to 7 years after the surgery. The examination took into account: occurrence of factors predisposing the disease to reappear (Dupuytren's diathesis), hand's function in patient's subjective opinion evaluated with DASH questionnaire and goniometrical measurement of the contracture.Results. Contracture reduction was observed in group I in 94% of patients. The average Total Loss of Extension before surgery was 123.85°, 3 months after operation - 54.51°. In group II the average Total Loss of Extension was 42.63°. Average DASH score in group 1 before surgery was 17.5. One month after the surgery a significant aggravation was observed (average score - 29.95). Three months after the surgery, there was an improvement and DASH score reduced to 15.02. The average DASH score in group II was 4.34. In both groups there was a correlation between patients' age and hand's function. Elder patients evaluated hand's function as better after the surgery. Recurrence of the disease was observed in 17% of patients in group 1 and 33% of patients in group II. Occurrence of predisposing factors (diathesis) increased probability of recurrence in group II. Significant differences in treatment results were not notified because of the surgery technique.Conclusions. This study reveals numerous problems with operative treatment of Dupuytren's disease: faint improvement of hand's function in primary months after surgery, large percentage of recurrences of the disease, a small number of patients with extension of fingers obtained as an outcome of the surgery.
1 - 9 - 2010
22 - 10 - 2010
- Thurston A: Dupuytren's disease-review article. J Bone Joint Surg 2003; 85(4): 469-75.
- Jagielski WJ: Ocena wyników leczenia operacyjnego przykurczu Dupuytrena z uwzględnieniem obiektywnych i subiektywnych parametrów sprawności ręki (rozprawa doktorska). Pomorska Akademia Medyczna, Szczecin 2005.
- Dias JJ, Braybrooke J: Dupuytren's contracture: An audit of the outcomes of surgery. J Hand Surg Br 2006; 31B(5): 514-21.[Crossref]
- Ebskov L, Boeckstyns M, Sorensen A: Results after surgery for severe Dupuytren's contracture: does a dynamic extension splint influence outcome? Scand J Plast Reconstr Surg Hand Surg 2000; 34: 155-60.
- Shaw R, Chong A, Zhang A et al.: Dupuytren's disease: History, Diagnosis and Treatment. Plast Reconstr Surg 2007; 9: 44-54.[Crossref]
- Boscheinen-Morrin J, Condly B. Ręka-podstawy terapii. Wyd. I. Elipsa-Jaim, Kraków 2003.
- Degreef I, Boogmans T, Steno P: Surgical outcome of Dupuytren's disease- no higher self-reported recurrence after segmental fasciecotmy. Eur J Plast Surg 2009; 32: 185-88.[Crossref]
- Armstrong JR, Hurren JS, Logan AM: Dermofasciectomy in the management of Dupuytren's disease. J Bone Joint Surg 2000; 81(1): 90-94.
- Hillel D, Skoff HD: The surgical treatment of Dupuytren's contracture: A synthesis of techniques. Plast Reconstr Surg 2004; 113(2): 540-44.
- Herweijer H, Dijkstra P, Nicolai J: Postoperative hand therapy In Dupuytren's disease. Disabil Rehabil 2007; 29(22): 1736-41.[Crossref][WoS]
- Hudak PC, Amadio C, Bombardier C: Development of an upper extremity outcome measure: the DASH (Disabilities of The Arm, Shoulder and Hand). Am J Ind Med 1996; 29: 602-08.[Crossref][PubMed]
- Sinha R, Cresswell R, Mason R: Functional benefit of Dupuytren;s surgery. J Hand Surg Br 2002; 27B(4): 378-81.[Crossref]
- Gudmundsson KG, Arngrimsson R, Sigfusson N et al.: Prevalence of joint complaints amongst individuals with Dupuytren's disease. Scand J Rheumatol 1999; 28: 300-04.
- Linden H, Klip H, Rijsen A: A comparison direct outcomes of percutaneous needle fasciotomy and limited fasciectomy for Dupuytren's disease: a 6-week follow-up study. J Hand Surg Am 2006; 31A(5): 717-24.
- McGrouther D.A.: Dupuytren's Contracture. W: Green P: Green's Operative Hand Surgery. Wyd. V. Philadelphia, Elsevier Churchill Livingstone, 2005.
- Żyluk A, Jagielski W: The effect of the severity of the Dupuytren's contracture on the function of the hand before and after surgery. J Hand Surg Br 2007;32E, 3:326-329.[Crossref][WoS]
- Draviaraj K, Chakrabarti I: Functional outcome after surgery for Dupuytren's contracture: A prospective study. J Hand Surg Am 2004; 29A(5): 804-08.[Crossref]
- Kaltenborn FM: Manualne mobilizacje stawów kończyn. Wyd. I. Rolewski, Toruń 1998.
- Kaniewska A: Subtotalna i częściowa fasciektomia w chorobie Dupuytrena z częściowym zajęciem rozcięgna dłoniowego ręki: prospektywne badania z randomizacją (praca doktorska). Centrum Medycznego Kształcenia Podyplomowego w Warszawie, Warszawa 2008.
Publication order reference