Abstract
IntroductionDupuytren’s disease (DD), commonly affecting European men, is generally treated with surgery.MethodsOrthopaedic and plastic surgeons who had been practicing for >3 and <30 years and operated on ≥5 patients with DD between September and December 2008 were surveyed in 12 European countries (Czech Republic, Denmark, Finland, France, Germany, Hungary, Italy, The Netherlands, Poland, Spain, Sweden and UK). The survey assessed procedures performed, factors influencing choice of procedure, use of physical therapy and recurrence. Descriptive statistics are reported.ResultsA total of 687 surgeons participated, including 579 orthopaedic and 108 plastic surgeons; 383 (56%) were hand surgeons. About 37% of surgeons performed percutaneous needle fasciotomy (PNF), 77% fasciotomy, 95% fasciectomy and 40% dermofasciectomy (DF). Surgeons’ choice of procedure was influenced by patient preferences, age, degree of contracture and recurrent disease. The percentage of surgeons prescribing physical therapy and the mean (standard deviation [SD]) duration of therapy increased with procedure complexity: PNF = 82%, 5.2 (3.9) weeks; fasciotomy = 94%, 5.3 (3.6); fasciectomy = 97%, 6.7 (5.1); and DF = 99%, 8.5 (6.4). Using survey responses, mean (SD) estimated recurrence rates decreased and estimated time to recurrence increased with procedure complexity—PNF = 44% (27%), 17 (15) months; fasciotomy = 30% (24%), 20 (18); fasciectomy = 20% (17%), 29 (23); and DF = 20% (19%), 33 (27).ConclusionsAcross Europe, patient and surgical factors influence the intention to use a surgical procedure. Fasciectomy was the most commonly performed procedure type and was associated with lower recurrence than PNF or fasciotomy.Electronic supplementary materialThe online version of this article (doi:10.1007/s12570-012-0091-0) contains supplementary material, which is available to authorized users.
Highlights
Dupuytren’s disease (DD), commonly affecting European men, is generally treated with surgery
The percentage of surgeons prescribing physical therapy and the mean duration of therapy increased with procedure complexity: PNF082%, 5.2 (3.9) weeks; fasciotomy094%, 5.3 (3.6); fasciectomy097%, 6.7 (5.1); and DF099%, 8.5 (6.4)
In a companion article [5] published in this issue, we report the results of a patient chart review, in which surgeons reviewed the charts of patients they treated with a surgical procedure for DD
Summary
Dupuytren’s disease (DD), commonly affecting European men, is generally treated with surgery. A number of different procedures are available for the surgical treatment of DD, including percutaneous needle fasciotomy (PNF; known as percutaneous needle aponeurotomy or needle fasciotomy), fasciotomy (subcutaneous or open), fasciectomy ( known as regional palmar fasciectomy or aponeurectomy) and dermofasciectomy (DF) [4]. In a companion article [5] published in this issue, we report the results of a patient chart review, in which surgeons reviewed the charts of patients they treated with a surgical procedure for DD. This article reports the results of the general experience of those same surgeons with surgical procedures performed for DD. Such information may be important when considering and judging the new treatment strategies available for DD [4]. Differences in surgeons’ responses by country and region are of interest and will be reported in an upcoming publication
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