The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome

Background/Aim. Dupuytren’s disease is a progressive disease of the palmar and digital fascial structures, with functional limitations. There are no clear recommendations about the optimal time of surgical repair, concerning the hand impairment. The aim of our study was to investigate the r...

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Main Authors: Stepić Nenad, Končar Jovana, Rajović Milica
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2017-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600103S.pdf
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author Stepić Nenad
Končar Jovana
Rajović Milica
author_facet Stepić Nenad
Končar Jovana
Rajović Milica
author_sort Stepić Nenad
collection DOAJ
description Background/Aim. Dupuytren’s disease is a progressive disease of the palmar and digital fascial structures, with functional limitations. There are no clear recommendations about the optimal time of surgical repair, concerning the hand impairment. The aim of our study was to investigate the relation between finger’s contracture degree and success of surgical treatment of the Dupuytren's disease. Methods. This prospective analysis included 60 patients operated on due to Dupuytren’s contracture. According to preoperative contracture degree of proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joint, patients were divided into three groups: the group 1: < 15°, the group 2: 15−30° and the group 3: > 30°. All the patients underwent operation of partial palmar fasciectomy. Postoperative improvement was expressed with contracture reduction INDEX. Results. There were 60 patients with 85 fingers affected. The groups 1, 2 and 3 had 22 (37%), 37 (62%) and 26 (43%) fingers with MCP contracture and 32 (37.4%), 24 (28.2%) and 29 (34.1%) fingers with PIP contracture, respectively. Postoperative contractures of MCP joint in these groups were 0, 0.135° and 5°, and of PIP joint 0, 2.08 ° and 16.89°, respectively. After six months all MCP contractures resolved, while PIP joint contracture in the group 3 remained 13.62°. The reduction INDEX was 98.85%, 97.62% and 75.52% in the groups 1, 2 and 3, respectively. There was a statistically significant difference in the INDEX value between the groups (p = 0.0001). Conclusion. The degree of PIP joint contracture is related to the outcome of surgical treatment of Dupuytren’s disease. Optimal results are achieved when contracture degree is between 15° and 30°. Surgical treatment of MCP joint contracture is successful regardless of the preoperative joint contracture degree.
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spelling doaj-art-a87aaaeb97f54c9c8c94e97add78d3432025-08-20T02:20:45ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202017-01-01741192310.2298/VSP150331103S0042-84501600103SThe influence of Dupuytren's disease fingers contracture degree on surgical treatment outcomeStepić Nenad0Končar Jovana1Rajović Milica2Military Medical Academy, Clinic for Plastic Surgery and Burns, Belgrade + University of defense, Faculty of Medicine of the Military Medical Academy, BelgradeMilitary Medical Academy, Clinic for Plastic Surgery and Burns, BelgradeMilitary Medical Academy, Clinic for Plastic Surgery and Burns, BelgradeBackground/Aim. Dupuytren’s disease is a progressive disease of the palmar and digital fascial structures, with functional limitations. There are no clear recommendations about the optimal time of surgical repair, concerning the hand impairment. The aim of our study was to investigate the relation between finger’s contracture degree and success of surgical treatment of the Dupuytren's disease. Methods. This prospective analysis included 60 patients operated on due to Dupuytren’s contracture. According to preoperative contracture degree of proximal interphalangeal (PIP) and metacarpophalangeal (MCP) joint, patients were divided into three groups: the group 1: < 15°, the group 2: 15−30° and the group 3: > 30°. All the patients underwent operation of partial palmar fasciectomy. Postoperative improvement was expressed with contracture reduction INDEX. Results. There were 60 patients with 85 fingers affected. The groups 1, 2 and 3 had 22 (37%), 37 (62%) and 26 (43%) fingers with MCP contracture and 32 (37.4%), 24 (28.2%) and 29 (34.1%) fingers with PIP contracture, respectively. Postoperative contractures of MCP joint in these groups were 0, 0.135° and 5°, and of PIP joint 0, 2.08 ° and 16.89°, respectively. After six months all MCP contractures resolved, while PIP joint contracture in the group 3 remained 13.62°. The reduction INDEX was 98.85%, 97.62% and 75.52% in the groups 1, 2 and 3, respectively. There was a statistically significant difference in the INDEX value between the groups (p = 0.0001). Conclusion. The degree of PIP joint contracture is related to the outcome of surgical treatment of Dupuytren’s disease. Optimal results are achieved when contracture degree is between 15° and 30°. Surgical treatment of MCP joint contracture is successful regardless of the preoperative joint contracture degree.http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600103S.pdfDupuytren contracturehandreconstructive surgical proceduresprognosis
spellingShingle Stepić Nenad
Končar Jovana
Rajović Milica
The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome
Vojnosanitetski Pregled
Dupuytren contracture
hand
reconstructive surgical procedures
prognosis
title The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome
title_full The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome
title_fullStr The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome
title_full_unstemmed The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome
title_short The influence of Dupuytren's disease fingers contracture degree on surgical treatment outcome
title_sort influence of dupuytren s disease fingers contracture degree on surgical treatment outcome
topic Dupuytren contracture
hand
reconstructive surgical procedures
prognosis
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600103S.pdf
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