50 years experience with Dupuytren's contracture in the Erlangen University Hospital – A retrospective analysis of 2919 operated hands from 1956 to 2006

Loos, Bernd; Valerij, Puschkin; Horch, Raymund E.

doi:10.1186/1471-2474-8-60

Cited by 101 publications

(73 citation statements)

References 42 publications

(66 reference statements)

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“…In the prayer sign test, where the palms of the hands are placed against each other, the early lesions in either hand are magnified compared with when each hand is placed separately on a table for the table test. In our study, LJM is associated with poor glycemic control and macrovascular complications which is associated with increased risks of developing LMJ by 2.2 times, and with manual labour since diabetic patients who were manual labourer had greater chance to develop LMJ by 7.7 times compared to non-manual laborers, this finding is in line with those reported by other authors, 17 regarding the gender being female was associated with increased risk of developing LJM. Dupuytren's contracture has been reported in (16%) of diabetic patients compared to controls with a prevalence of (2%).…”

Section: Data Management and Statistical Analysissupporting

confidence: 92%

Hand abnormalities in diabetics: Prevalence and predictors in Erbil city

Albarzinji

Mohammed²

2017

ZJMS

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Results: Of the total 100 diabetic patients, 63% had macrovascular complications and 60% had one or more hand disorders. Limited joint mobility (47% vs. 18%, respectively; P = 0.0001) and Dupuytren's contracture (16% vs. 2%, respectively; P = 0.001) were significantly higher in type 2 diabetes mellitus patients than in the controls, but not trigger finger. These hand soft-tissue changes correlated significantly with poor glycemic control. Conclusion: This study shows a high prevalence of hand disorders in diabetic patients with the limited joint mobility being the most common hand disorder. The hand soft tissue changes are under recognized in diabetic patients, occurring in 60% of the cases. We recommend that physicians should consider examining the periarticular region of the joints in the hands in each diabetic patient.

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Section: Data Management and Statistical Analysissupporting

confidence: 92%

Hand abnormalities in diabetics: Prevalence and predictors in Erbil city

Albarzinji

Mohammed²

2017

ZJMS

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“…5 and 6). The relevance of some of the many implicated etiological factors such as alcohol abuse, cirrhosis of the liver, smoking, epilepsy, diabetes mellitus, and hypercholesterolemia on the prevalence of DD is questioned [17,57,92].…”

Section: Significance Of Associated Risk Factors and Prevalence Of Ddmentioning

confidence: 99%

Epidemiological Evaluation of Dupuytren's Disease Incidence and Prevalence Rates in Relation to Etiology

Hindocha

McGrouther

Bayat

2009

Hand (New York, N,Y.)

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Dupuytren's Disease (DD) is a common, fibroproliferative disorder affecting the palmar surface of the hands which is often irreversible and progressive. Understanding the epidemiology of DD is important in order to provide clues to its etiopathogenesis. This review aims to evaluate the epidemiological studies carried out in DD since 1951. Studies evaluating the epidemiology of DD were searched using Medline, Pubmed, and Scopus which dated back from 1951 to current date. Inclusion criteria were any studies investigating the prevalence or incidence of DD in any population group. A total of 620 articles were cited. Forty-nine studies were subsequently identified as relevant to evaluating the epidemiology of DD. The prevalence of DD in all studies increased with age with a male to female ratio of approximately 5.9:1. Prevalence rates ranged from 0.2% to 56% in varying age, population groups, and methods of data collection. The highest prevalence rate was reported in a study group of epileptic patients. Although, only one study calculated the incidence (as opposed to prevalence) of DD to be equal to 34.3 per 100,000 men (0.03%). In conclusion, the prevalence of DD in different geographical locations is extremely variable, and it is not clear whether this is genetic, environmental, or a combination of both. The majority of the prevalence studies have been conducted in Scandinavia or the UK, and the vast changes in population structure, the changes in prevalence of associated diseases, and the change in diagnostic criteria of DD makes understanding the epidemiology of this condition difficult.

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“…28 However, more recent studies in the UK and Germany have reported almost equal involvement of both hands. 30 …”

Section: Epidemiology and Prognosismentioning

confidence: 99%

Collagenase clostridium histolyticum for the treatment of Dupuytren’s contracture: systematic review and economic evaluation

Brazzelli

Cruickshank

Tassie

et al. 2015

Health Technol Assess

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BackgroundDupuytren’s disease is a slowly progressive condition of the hand, characterised by the formation of nodules in the palm that gradually develop into fibrotic cords. Contracture of the cords produces deformities of the fingers. Surgery is recommended for moderate and severe contractures, but complications and/or recurrences are frequent. Collagenase clostridium histolyticum (CCH) has been developed as a minimally invasive alternative to surgery for some patients.ObjectivesTo assess the clinical effectiveness and cost-effectiveness of collagenase as an alternative to surgery for adults with Dupuytren’s contracture with a palpable cord.Data sourcesWe searched all major electronic databases from 1990 to February 2014.Review methodsRandomised controlled trials (RCTs), non-randomised comparative studies and observational studies involving collagenase and/or surgical interventions were considered. Two reviewers independently extracted data and assessed risk of bias of included studies. A de novo Markov model was developed to assess cost-effectiveness of collagenase, percutaneous needle fasciotomy (PNF) and limited fasciectomy (LF). Results were reported as incremental cost per quality-adjusted life-year (QALY) gained. Deterministic and probabilistic sensitivity analyses were undertaken to investigate model and parameter uncertainty.ResultsFive RCTs comparing collagenase with placebo (493 participants), three RCTs comparing surgical techniques (334 participants), two non-randomised studies comparing collagenase and surgery (105 participants), five non-randomised comparative studies assessing various surgical procedures (3571 participants) and 15 collagenase case series (3154 participants) were included. Meta-analyses of RCTs assessing CCH versus placebo were performed. Joints randomised to collagenase were more likely to achieve clinical success. Collagenase-treated participants experienced significant reduction in contracture and an increased range of motion compared with placebo-treated participants. Participants treated with collagenase also experienced significantly more adverse events, most of which were mild or moderate. Four serious adverse events were observed in the collagenase group: two tendon ruptures, one pulley rupture and one complex regional pain syndrome. Two tendon ruptures were also reported in two collagenase case series. Non-randomised studies comparing collagenase with surgery produced variable results and were at high risk of bias. Serious adverse events across surgery studies were low. Recurrence rates ranged from 0% (at 90 days) to 100% (at 8 years) for collagenase and from 0% (at 2.7 years for fasciectomy) to 85% (at 5 years for PNF) for surgery. The results of the de novo economic analysis show that PNF was the cheapest treatment option, whereas LF generated the greatest QALY gains. Collagenase was more costly and generated fewer QALYs compared with LF. LF was £1199 more costly and generated an additional 0.11 QALYs in comparison with PNF. The incremental cost-effectiveness ratio was £10,871 per QALY gained. Two subgroup analyses were conducted for a population of patients with moderate and severe disease and up to two joints affected. In both subgroup analyses, collagenase remained dominated.LimitationsThe main limitation of the review was the lack of head-to-head RCTs comparing collagenase with surgery and the limited evidence base for estimating the effects of specific surgical procedures (fasciectomy and PNF). Substantial differences across studies further limited the comparability of available evidence. The economic model was derived from a naive indirect comparison and was hindered by a lack of suitable data. In addition, there was considerable uncertainty about the appropriateness of many assumptions and parameters used in the model.ConclusionsCollagenase was significantly better than placebo. There was no evidence that collagenase was clinically better or worse than surgical treatments. LF was the most cost-effective choice to treat moderate to severe contractures, whereas collagenase was not. However, the results of the cost–utility analysis are based on a naive indirect comparison of clinical effectiveness, and a RCT is required to confirm or refute these findings.Study registrationThis study is registered as PROSPERO CRD42013006248.FundingThe National Institute for Health Research Health Technology Assessment programme.

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50 years experience with Dupuytren's contracture in the Erlangen University Hospital – A retrospective analysis of 2919 operated hands from 1956 to 2006

Cited by 101 publications

References 42 publications

Hand abnormalities in diabetics: Prevalence and predictors in Erbil city

Hand abnormalities in diabetics: Prevalence and predictors in Erbil city

Epidemiological Evaluation of Dupuytren's Disease Incidence and Prevalence Rates in Relation to Etiology

Collagenase clostridium histolyticum for the treatment of Dupuytren’s contracture: systematic review and economic evaluation

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