Injury-induced variant of Dupuytren’s contracture - incidence and specific clinical expression

Abstract

Introduction Dupuytren's contracture (DC) is a chronic fibroproliferative illness of the palm aponeurosis, resulting in progressive contractures of metacarpophalangeal and proximal interphalangeal joints, thus impairing hand function. [1-5] The origin of this illness comprehends an interface between genetic susceptibility and multifactorial environmental and lifestyle factors. A specific form of DC, linked to acute hand injuries, was observed and is discussed until now. However, definite conclusions concerning this concept are sparse. [6 - 18] Aim We aimed to:1. Analyse the incidence of injury-related cases of Dupuytren's contracture in Lithuanian population.2. Compare the clinical expressions of injury-induced and standard cases of DC. Methods We enrolled patients, who underwent day-case surgery of primary DC in the Dept. of Plastic and Reconstructive surgery, Hospital of LUHS. Approvals for this research were issued by Kaunas Regional Biomedical Research Ethics Commitee (2019-03-08 No. BE-2-21). Clinical signs and physical examination was used for diagnosis of DC. Demographic and behavioural patterns, DC diathesis (family history, bilateral involvement, male gender, early-onset (<50years), ethnicity), detailed history of previous hand injuries and conditions, duration of symptoms were acquired from patients and their medical documentation. Goniometric testing was used for objective evaluation of digit contractures (PIP and MP joints). Staging of DC was done according to Tubiana classification. Patients with multiple digit contractures were counted as a single case, taking the finger with the most expressed contracture as are ference. Patients with a positive history of trauma were evaluated by „Criteria for recognition of Dupuytren‘s. contracture after acute injury“ (established by Elliot and Regoowansi, 2004), creating injury-induced and non injury-induced patient groups. Data were analyzed using Statistical Package for Social Sciences (SPSS). Tests of Normality (Shapiro-Wilk) displayed normally distributed continuous data, expressed in years. The Chi-square test [...].