Preferred treatment options of German hand surgeons in Dupuytren disease

Abstract

This study was performed to determine whether between 2015 and 2017 there has been a change in the preferred method of treatment of Dupuytren disease by German hand surgeons, especially with respect to percutaneous needle fasciotomy. In 2015 and 2017, 530 members of the German Society for Surgery of the Hand were invited to take part in an online survey, asking for their preferred treatment for Dupuytren disease, including decision criteria and in relation to Tubiana stages. 110 and 101 responders, respectively, took part. In both surveys, 86 surgeons stated that they treated up to 100 patients per year (Group A), while 24 and 15 surgeons, respectively, treated more than 100 Dupuytren patients annually (Group B). In both surveys, limited fasciectomy was found to be the preferred method (82.9 % and 87.7 %). Treatment with clostridial collagenase is performed only sporadically (1.3 % or 1.4 %). Percutaneous needle fasciotomy is of minor relevance in stage I (19.1 % or 10.9 %) and II (16.4 % or 9.9 %) and is performed mainly by surgeons who treat more than 100 patients per year.The most important criterion for the decision on what treatment should be chosen was "best outcome" (54.3 % and 68.6 %). Between 2015 and 2017, there was no great change in the choice of treatment for Dupuytren disease in Germany. In particular, there was no increase in PNF procedures.