Dupuytren’s Contracture: An Audit of the Outcomes of Surgery

Abstract

This multi-centre postal questionnaire study was conducted by the Audit Committee of the BSSH to assess the outcomes of surgery for Dupuytren's Contracture using subjective data provided by 1177 patients at a mean follow-up of 27 (SD 8) months after surgery. Surgery for Dupuytren's contracture achieved a high rate of full, or almost full, correction in 826 patients (75%) but had a high incidence of post-operative patient-reported complications of 46%. A higher complication rate was seen in those patients with worse initial deformities. The rate of contracture recurrence or persistence was 158 of 1037 (15%). The severity of contracture correlated with the final hand function measured using the PEM score. Recurrence was more common in patients with greater initial deformity. Recurrence was less common if good correction was achieved at surgery. The relevance and limitations of this data are discussed.

Unique microRNA profile in Dupuytren's contracture supports deregulation of β-catenin pathway

“…Scoring systems are based on the personal history of the patient and severity of the contracture. 44 Surveys suggest underlying molecular activity as responsible for recurrent Dupuytren's contracture. 29 In our analysis, we compared patients with non-recurrent and recurrent Dupuytren's contracture, but detected no miRNAs with significant differential expression between the two patient groups (q40.05).…”

Hand Function and Quality of Life Before and After Fasciectomy for Dupuytren Contracture

“…We did not measure passive ROM, which could have helped to differentiate between contracture and motion lag. However, from the patients' view, the compromised function is what matters regardless of its cause (12). At 12 months, the majority had regained sufficient flexion to allow a functional ROM, i.e.…”

“…Previous research has focused on outcomes related to surgical techniques, decrease of extension deficit, or disease recurrence (3,(10)(11)(12) and show larger improvement of the extension deficit in the metacarpophalangeal (MCP) joint than in the proximal interphalangeal (PIP) joint (10). Further, a more severe degree of contracture before surgery or contracture of the PIP joint has been associated with residual contracture after surgery (10,13,14).…”

Management of contractures: A five-year experience at Komfo Anokye Teaching Hospital in Kumasi

“…Dermatofasciectomy may be done for recurrent disease. 26 It is known that good correction can be achieved by surgery but treatment has a high complication rate and a significant rate of recurrent contracture, especially with more severe initial deformities. Those with good initial correction are less likely to recur.…”

“…Those with good initial correction are less likely to recur. 26 About 14 % of the patients presented with sociocultural handicaps associated with contractures located in special sites such as the perineum, groin, head and neck. The perineal and groin contractures involved the pubic area, the external genitalia and the peri-anal area.…”