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Functional outcome and complications following surgery for Dupuytren’s disease: a multi-centre cross-sectional study

Rodrigues, J.N.; Zhang, Weiya; Scammell, Brigitte E.; Chakrabarti, I.; Russell, P.G.; Fulllilove, S.; Davidson, D.; Davis, T.R.C.

Authors

J.N. Rodrigues

Brigitte E. Scammell

I. Chakrabarti

P.G. Russell

S. Fulllilove

D. Davidson

T.R.C. Davis



Abstract

Variables associated with recurrent Dupuytren’s disease, or a ‘diathesis’, have been investigated, but those associated with functional outcome and complications are less well studied. Outcomes 1 or 5 years after an aponeurotomy, fasciectomy or dermofasciectomy were assessed by patient interview and examination at five UK centres. A total of 432 procedures were studied. The reoperation rate did not differ at 1 year (p = 0.396, Chi-square test with Monte Carlo simulation), but was higher after aponeurotomy in the 5-year group (30%, versus 6% after fasciectomy and 0% after dermofasciectomy, p = 0.003, Chi square test with Monte Carlo simulation). Loss of function (DASH>15) did not differ between procedures at 5 years, even when reoperation and other variables were controlled. Diabetes, female gender and previous ipsilateral surgery were associated with poorer function in logistic regression analysis. The variables associated with poor function after treatments differ from diathesis variables. Aponeurotomy had lower complication rates than fasciectomy and dermofasciectomy. This may counterbalance the former’s higher recurrence rate and explain why aponeurotomy demonstrated similar long-term functional outcome compared with excisional surgery in this study.

Citation

Rodrigues, J., Zhang, W., Scammell, B. E., Chakrabarti, I., Russell, P., Fulllilove, S., …Davis, T. (in press). Functional outcome and complications following surgery for Dupuytren’s disease: a multi-centre cross-sectional study. Journal of Hand Surgery (European Volume), https://doi.org/10.1177/1753193416660045

Journal Article Type Article
Acceptance Date Jun 24, 2016
Online Publication Date Jul 29, 2016
Deposit Date Oct 31, 2016
Publicly Available Date Oct 31, 2016
Journal Journal of Hand Surgery (European Volume)
Print ISSN 1753-1934
Electronic ISSN 2043-6289
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1177/1753193416660045
Keywords Dupuytren’s contracture, Dupuytren’s disease, patient-reported outcome measures, late outcome, complications, function
Public URL http://eprints.nottingham.ac.uk/id/eprint/38094
Publisher URL http://jhs.sagepub.com/content/early/2016/08/05/1753193416660045
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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