Advantages and Disadvantages of Various methods for Dupuytren’s Contracture

Background. The data available in the literature on the features of the clinical course and functional prognosis of Dupuytren`s disease in women is contradictory, there are no data on comparative pathomorphological studies of palmar fibromatosis in men and women.The aim of the study was to identify possible differences in the clinical and pathomorphological characteristics of Dupuytren`s disease in men and women.Materials and Methods. 228 cases of men and 39 women (6:1) who underwent fasciectomy in 2013–2019 period were analyzed. Histomorphometry of paraffin sections of the patient`s palmar fascia specimens of 24 men and 24 women was performed.Results. Men ranged in age from 26 to 83, the median age is 3 years more in women (p<0.001), but the median age of Dupuytren`s disease debut is 2 years less in women (p<0.001). The frequency of contractures of the 3rd–4th degree was 35.9% in the group of women and 65% in the group of men (p<0.001). In the group of women the frequency of both hands involvement is 15.2% higher, I–III fingers involvement is 8.7% higher, recurrent contracture is 11.1% higher (p<0.1). Histomorphometric analysis of the patient`s palmar fascia specimens showed that women compared to men had 10.23% less adipose tissue (p<0.001), 7.87% less dense connective tissue (p<0.05), but the proportion of hyperplastic connective tissue was 20.31% higher.Conclusion. Dupuytren`s disease is less common in women, than men. Women seek surgical treatment earlier than men. The tendency to functional limitations intensification and the risk of recurrence in women is associated with higher expression of hyperplastic changes in the fascial structures of the hand.

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Comparative Clinical and Pathomorphological Characteristics of Dupuytren’s Contracture in Men and Women

Щудло

Ступина

Щудло

et al. 2021

Traumatology and Orthopedics of Russia

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Actual Aspects of Surgical Treatment of Dupuytren's Disease (Literature Review)

Naumenko¹,

Kondrashova

2021

HOTP

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Relevance. The variety of manifestations of Dupuytren's disease, caused by the degree of lesions of the palmar aponeurosis, the duration of the disease, the nature of professional activity, and concomitant pathology of patients, has led to the development of numerous surgical techniques with different levels of effectiveness in the acute and long-term periods. A wide discussion of the issues of Dupuytren's disease in the domestic and foreign periodicals, the analysis of treatment methods, complications and rehabilitation indicate the urgency of the problem and the expediency of further research. Objective: a retrospective analysis of the leading literary sources devoted to the surgical treatment of Dupuytren's disease; the definition of modern approaches to surgical tactics and restoration of hand function. Results. The analysis of literature sources showed the advantages of differentiated approaches to the surgical treatment of Dupuytren's disease, depending on the severity of the disease. With mild and moderate lesions, there is a significant increase in needle aponeurectomy. In severe forms, the segmental aponeurectomy technique is preferred over the total one. There is some discrepancy in carrying out surgical mobilization of the proximal interphalangeal joint and the need to achieve a functional position as a result of treatment. The tactics of surgical treatment and rehabilitation of Dupuytren's disease requires an individual approach, taking into account the age and severity of the disease, and tends to spread minimally invasive fasciotomy techniques.

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Advantages and Disadvantages of Various methods for Dupuytren’s Contracture

Cited by 2 publications

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Comparative Clinical and Pathomorphological Characteristics of Dupuytren’s Contracture in Men and Women

Comparative Clinical and Pathomorphological Characteristics of Dupuytren’s Contracture in Men and Women

Actual Aspects of Surgical Treatment of Dupuytren's Disease (Literature Review)

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