Current trends in the surgical management of Dupuytren’s disease in Europe: an analysis of patient charts

Abstract

IntroductionDupuytren’s disease (DD) causes progressive digital flexion contracture and is more common in men of European descent.MethodsOrthopaedic and plastic surgeons in 12 European countries (the Czech Republic, Denmark, Finland, France, Germany, Hungary, Italy, The Netherlands, Poland, Spain, Sweden and the UK) with >3 and <30 years experience reviewed the medical charts of five consecutive patients they had treated surgically for DD in 2008. Descriptive statistics are reported.ResultsIn total, 3,357 patient charts were reviewed. Mean (standard deviation) patient age was 61.9 (10.2) years; 81% were men. At the time of the procedure, 11% of patients were at Tubiana stage Ia (0–20° total flexion); 30%, stage Ib (21–45°); 34%, stage II (46–90°); 17%, stage III (91–135°); and 5%, stage IV (>135°). Percutaneous needle fasciotomy was performed in 10%, fasciotomy in 13%, fasciectomy in 69% and dermofasciectomy (DF) in 6% of patients. After surgery, fingers improved a mean of 1.9 Tubiana stages, and 54% of patients had no nodules or contracture. The rate of reported complications during the procedure was 4% overall (11% in patients undergoing DF). The most common postoperative complications reported were haematoma (8%), wound healing complications (6%) and pain (6%). No postoperative complications were reported in 77% of patients.ConclusionsIn this European study of more than 3,000 patients with DD, most patients were diagnosed at Tubiana stage I or II, the majority received fasciectomy and more than half had no nodules or contracture remaining after surgery.Electronic supplementary materialThe online version of this article (doi:10.1007/s12570-012-0092-z) contains supplementary material, which is available to authorized users.