Treatment practice for Dupuytren disease in Belgium before 2020: results from an online survey

Abstract

The treatment of Dupuytren disease (DD) continues to evolve. New insights in risk factors for recurrence and new treatment modalities have changed the management strategies for DD over the past decades. However, several differences may remain between these insights and their clinical application. The current tendencies in management of Dupuytren disease, were investigated in a web-based survey. The survey was sent to all members of the Belgian Hand Group, the professional organisation of hand surgeons in Belgium. The participants indicated their preferred treatment for clinical cases and answered questions on the use and timing of splinting, physiotherapy, medication and adapting the management depending on fibrosis diathesis. These findings were compared to recommendations found in the literature. Forty out of 135 surveyed members of the Belgian Hand Group completed the survey and 7 responded incompletely, yielding a response rate of 35% for most questions. This is comparable to similar studies. There appeared to be still room for debate on surgical techniques for difficult cases. CCH use increased since reimbursement became available in Belgium, mainly due to satisfying clinical results for patient and surgeon. The survey demonstrated a wide variety in pre- and postoperative splinting protocols, but consensus existed with the literature on postoperative night-time application of orthoses for 7 to 12 weeks.

Four Corner Fusion Vs. Proximal Row Carpectomy for The Treatment of Scapholunate Advanced Collapse

“…The Mean age from all studied was 50.23±15.9 and 56.89±14.36 between 4CF and PRC groups with no significant difference. ; with youngest mean age in Vanhove et al [2] study; and oldest mean age in Van Nuffel et al [21] study.…”

“…Between trials, there was agreement and no discernible heterogeneity. (18) 10 NA 10 NA -----------Gaston et al (19) 18 73.0±8.5 18 63.0±3.5 3.815 0.002* Vanhove et al (2) 15 69.0±22.6 15 79.0±26.3 1.882 0.059 Andreas et al (20) 17 NA 30 NA -----------Van Nuffel et al, (21) 0.76-8.54 There was established homogeneity among investigations. After measuring all parameters, no bias is taken into consideration for variations in outcomes between studies that are not the product of chance.…”

Pyrocarbon Arthroplasty Implants in the Upper Extremity: A Systematic Review of Outcomes and Pooled Analysis of Complications

“…Forty-seven studies were included in the pooled quantitative analysis of overall complication rates; a descriptive summary of complications identified from each individual study is presented. ( See Table, Supplemental Digital Content 3 , which shows the incidence of complications 33–79 ; information pertaining to diagnosis and digits involved, where specified, is presented as well, http://links.lww.com/PRS/E695.) When considering all joints of the upper extremity, the total complication rate was determined to be 25.8 percent ( n = 530 of 2051 joints), whereas the complication rate for the hand and wrist combined was 28.2 percent ( n = 476 of 1687 joints).…”

“…[ See Table, Supplemental Digital Content 2 , which shows the qualitative data synthesis. 33–79 *Pertaining to patients without complications, as specified in study **for pyrocarbon ( n = 40) and metal implants ( n = 14) and arthroplasty implants combined; follow-up for patients from the pyrocarbon group alone was not specified, http://links.lww.com/PRS/E694. ]…”

Limited Intercarpal Fusion vs. Proximal Row Carpectomy in the treatment of SLAC or SNAC Wrist, results after 3.5 years.

“…Numerous studies compare the outcomes of 4CF with PRC [7][8][9][10][11]. Generally, when comparing PRC with 4CF, PRC results in a better range of motion (ROM) and 4CF in better grip strength.…”