Dupuytren's contracture treatment evaluation: effectiveness of limited partial fasciectomy

Abstract

Introduction Dupuytren‘s contracture (DC) is a progressing fibroproliferative hand disorder of polygenetic and multifactorial origin [1,2]. DC presents as thickening of the palmar aponeurosis [1]. It results in the development of longitudinal bands and formation of contractures in the digits [1,2]. The prevalence of DC ranges widely from 2 to 42 % [3,4]. Treatment of DC is aimed at excision or fragmentation of the fibrous bands and the residual extension deficit is established as a hallmark of treatment effectiveness [5]. Limited partial fasciectomy is a widely accepted traditional surgical approach [6,7]. Even though recent decade has marked increased interest in minimally invasive methods there is still lack of studies evaluating limited partial fasciectomy in a modern surgery setting. Aim Evaluate limited partial fasciectomy effectiveness in treatment of DC by comparing pre- and postoperative extension deficit of the digits and disability of the upper limb. Methods A prospective study was performed, including patients admitted to the department of Plastic and Reconstructive Surgery, Hospital of LUHS Kaunas Clinics for limited partial fasciectomy in 2017 – 2019. Diagnosis of DC was based on physical examination. Extension deficit was measured by goniometry, 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 a reference. Furthermore, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was performed. Follow-up examinations were carried out after 6 and 12 months postoperatively. Data was analyzed using IBM SPSS Statistics 23.0. The repeated measures ANOVA with post hoc tests was used to compare means of normally distributed data according to Kolmogorov-Smirnov and Shapiro-Wilk tests. For verification of hypothesis significance level of p<0.05 was chosen. Resu [...].