Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 1)

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

Authors:
Nenad Stepić, Jovana Končar, Milica Rajović

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Background/Aim. Dupuytren’s disease is a progressive dis-ease of the palmar and digital fascial structures, with func-tional limitations. There are no clear recommendations about the optimal time of surgical repair, concerning the hand im-pairment. 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 pro-spective analysis included 60 patients operated on due to Du-puytren’s contracture. According to preoperative contracture degree of proximal interphalangeal (PIP) and metacarpopha-langeal (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 pa-tients 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, respec-tively. 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 re-gardless of the preoperative joint contracture degree.