MANAGEMENT OF DUPUYTREN’S DISEASE- OUR EXPERIENCE IN A TERTIARY CARE INSTITUTE

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MANAGEMENT OF DUPUYTREN’S DISEASE- OUR EXPERIENCE IN A TERTIARY CARE INSTITUTE

Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 24

Abstract

BACKGROUND Dupuytren’s disease is a benign fibroproliferative disorder that causes the fingers to be drawn into the palm by formation of new tissue under the glabrous skin of the hand. This disorder causes functional limitations, but it can be treated through a variety of surgical techniques with good outcome. Aims and Objectives- To assess the benefits of surgical procedures (Limited superficial fasciectomy and Radical superficial fasciectomy) for treatment of Dupuytren’s disease of the hand including fingers (ring, middle, little, index and thumb). MATERIALS AND METHODS This is a prospective study. We included patients with Dupuytren’s disease, who were categorised into groups receiving surgical intervention for the disease (nodules, cords and contracture bands) of the index, middle, ring, little finger, thumb and palm. Luck’s criteria were considered for categorising the patients. Their records and photographs were reviewed along with histology reports. We analysed outcomes into the following categories: (1) Hand function, (2) Early objective outcomes (e.g. correction of angular deformity) and (3) Late objective outcomes (e.g. recurrence, disease progression). Settings and Study Design- A retrospective study/ descriptive study of 30 patients who underwent surgical intervention for Dupuytren’s disease for a period of five years from 2011 to 2016 at Kempegowda Institute of Medical Sciences and Research Centre, Bangalore were considered in this study. RESULTS In our study of 30 patients, 29 patients were males and majority were in the age group of 45 to 70 years. We did not encounter any patients with Plantar Fasciitis/ Peyronie’s disease or any related disease complex, but 6 patients had Diabetes Mellitus. There was positive family history in 3 patients with bilateral disease noted in 18 patients. Hand function improved in majority (83.33%) of patients and we were able to correct angular deformities. Disease recurrence was seen in 3 patients with progression seen in 3 patients. We did not have any neurovascular complications in our study. CONCLUSION Understanding current treatment patterns, we were able to achieve good outcome in all our patients with single digit affliction and unilateral disease. Patients presenting with bilateral advanced disease were left with residual contracture. Overall improvement was observed in all our patients with the current treatment modalities (Limited superficial fasciectomy and Radical superficial fasciectomy) coupled with concurrent continuous and aggressive physiotherapy

Authors and Affiliations

Mahesh S. G, Adarsh M. S, Balaji R, Mali Chetan

Keywords

Dupuytren’s Disease Palmar Nodule Finger Contracture.

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EP ID EP450558
DOI 10.14260/jemds/2018/654
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