Abstract
Multiple studies have reported the effectiveness of treatment on contracture reduction in Dupuytren's disease. However, very few studies have attempted to quantify to which extent patient and disease characteristics influence the chance of achieving a straight finger after surgery. Therefore, the aim of this study is to explore to which extent pre-operative patient and disease characteristics can reliably predict a straight finger after surgery for Dupuytren's disease. In total, 812 and 281 patients, who underwent a limited fasciectomy or needle fasciotomy, respectively, were included in the final analyses. Analysis was performed using a logistic modeling framework. For both treatments, the combination of the extension deficit at baseline; which finger is most affected, which joint is most affected, and the number of affected fingers provided reliable predictions. Classical patient characteristics, such as age and sex, had no additional predictive value. The models presented in this study provide reliable predictions and could be helpful in informing patients and managing their expectations.
Highlights
Finger contracture in patients with Dupuytren’s disease can be treated with a variety of treatments
812 patients treated with a limited fasciectomy and 287 patients treated with a needle fasciotomy were included in this study
Patients undergoing a limited fasciectomy had a mean total active extension deficit (TAED) of 64 degrees and 12% of the patients had 3 or more affected fingers
Summary
Finger contracture in patients with Dupuytren’s disease can be treated with a variety of treatments. The disease is as yet incurable, each treatment has its own indications depending on the severity of the disease and the preference of the patient[1,2,3].In general, more severe cases of Dupuytren’s disease achieve a better contracture reduction with a limited fasciectomy, whereas patients who have mild to moderate contractures can be effectively treated with both limited fasciectomy and needle fasciotomy[4,5]. Dermofasciectomy is mainly used in patients with recurrent Dupuytren’s disease and severe diathesis. Different indications exist for various treatments, all treatments for Dupuytren’s disease share the common aim of improving hand function by straightening the affected finger(s)
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