Day Care Surgery for Advanced Dupuytren’s Contracture

Ebskov, Lars Bo; Boeckstyns, Michel E. H.; Sörensen, Allan Ibsen; Haugegaard, M.

doi:10.1016/s0266-7681(97)80060-5

Cited by 15 publications

(22 citation statements)

References 2 publications

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“…Robins et al 18 had no nerve lesions in 50 primary cases, and Makela et al 8 had an incidence of 1%. Ebskov et al 16 found an incidence of 9.6% in 52 primary cases and 4.2% in recurrent cases. For the minor complications, differences between primary and recurrent surgery could not be found.…”

Section: Discussionmentioning

confidence: 95%

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

Coert¹,

Nerin²,

Meek³

2006

Annals of Plastic Surgery

101

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Many different surgical techniques are still being used for Dupuytren disease. The outcome of 558 consecutive operations with 1 technique was reviewed. Distinct subgroups were made to detect risk factors for a poor outcome and complications. The mean follow-up time was 7.3 years. Younger patients (first surgery before 45 years) were operated significantly more than older patients (after 45 years). Results of contracted proximal interphalangeal (PIP) joints were significantly worse than other joints. The overall complication rate was 26%. Nerve lesions occurred in 7.7%. Young age proved to be a prognostic factor for the total number of operations. The contracted PIP joints will lead to more complications and poorer result. The risk at nerve lesion, necrosis, and infection are higher for recurrent surgery. These findings can be used in advising patients.

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Section: Discussionmentioning

confidence: 95%

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

Coert¹,

Nerin²,

Meek³

2006

Annals of Plastic Surgery

101

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“…A small percentage (1%) was represented by trauma surgeons [11]. In a 6-month study of 76 consecutive Danish patients with advanced Dupuytren's disease, day case surgery was performed on 96% (50/52) of patients with primary contracture and 79% (19/24) of those with recurrent disease [12]. Senior registrars from the Department of Orthopaedic Surgery performed 89% of primary surgeries and 50% of recurrent surgeries.…”

Section: Discussionmentioning

confidence: 99%

Dupuytren's contracture: a retrospective database analysis to assess clinical management and costs in England

Gerber

Perry

Thompson

et al. 2011

BMC Musculoskelet Disord

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BackgroundDupuytren's disease is a fibro-proliferative disorder affecting ~3-5% of the UK population. Current surgical treatments for Dupuytren's contracture (DC) include fasciectomy and fasciotomy. We assessed the clinical management of DC in England over a 5-year period; associated NHS costs were assessed for a 1-year period.MethodsHospital Episode Statistics were extracted from April 2003 to March 2008 for patients with Palmar Fascial Fibromatosis (ICD10 = M720) and DC-related procedures. Variables included demographics, OPCS, patient status and physician specialty. To estimate 2010-2011 costs, HRG4 codes and the National Schedule of Tariff 2010-11-NHS Trusts were applied to the 2007-2008 period.ResultsOver 5 years, 75,157 DC admissions were recorded; 64,506 were analyzed. Mean admissions per year were 12,901 and stable. Day cases increased from 42% (2003-2004) to 62% (2007-2008). The percent of patients having two or more admissions per year increased from 5.5% in 2003-2004 to 26.1% in 2007-2008. Between 2003 and 2007, 91% of procedures were Fasciectomy. Revision of Fasciectomy and Fasciotomy each accounted for ~4%; Amputation for 1%. In 2007, classification was extended to identify Digital Fasciectomy, its Revision and Dermofasciectomy. In 2007-2008, admissions were: 70% Palmar Fasciectomy, 16% Digital Fasciectomy, 1.3% Other Fasciectomy, 4.4% Revision of Palmar Fasciectomy, 1.3% Revision of Digital Fasciectomy, 3.8% Division of Palmar Fascia, 2.6% Dermofasciectomy and 1.1% Amputation. 79% of cases were overseen by trauma and orthopaedic surgeons, 19% by plastic surgeons. Mean (±SD) inpatient hospital length of stay was 1.5 (±1.4) days in 2003-2004 and 1.0 (±1.3) days in 2007-2008. Total estimated costs for 1 year (2010-2011) were £41,576,141. Per-patient costs were £2,885 (day case) and £3,534 (inpatient). Costs ranged from £2,736 (day-case Fasciectomy) to £9,210 (day-case Revision Digital).ConclusionsBetween 2003 and 2008, fasciectomy was the most common surgical procedure for DC in England. While procedure rates and physician specialties varied little, there was a reversal in surgical venue: inpatient operations decreased as day-case procedures increased. The change is likely due to economic trends and changes to the healthcare system. Estimated costs for 2010-2011 varied by procedure type and patient status. These findings can be used to understand clinical management of DC and guide healthcare policy.

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“…Reported complication rates for surgical fasciectomy have been reported from 17% to 29%. 11,12,16,17 Hematoma and skin necrosis remain the most common complications, and nerve injury rates range from 0% to 9.6%. 12,17-19 Disease recurrence following palmar fasciectomy ranges from 41% to 54% at 5 years, 7-9 and 15% of these patients will require reoperation to address disease recurrence.…”

Section: Discussionmentioning

confidence: 99%

Collagenase Injection as Nonsurgical Treatment of Dupuytren's Disease: 8-Year Follow-Up

Watt

Curtin

Hentz

2010

The Journal of Hand Surgery

133

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Day Care Surgery for Advanced Dupuytren’s Contracture

Cited by 15 publications

References 2 publications

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

Results of Partial Fasciectomy for Dupuytren Disease in 261 Consecutive Patients

Dupuytren's contracture: a retrospective database analysis to assess clinical management and costs in England

Collagenase Injection as Nonsurgical Treatment of Dupuytren's Disease: 8-Year Follow-Up

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