Dupuytren’s Disease: A Clinical Retrospective Study

Objective:To summarize our experience of operative treatment in patients withDupuytren’s Disease, and explore the relation between surgical complications,recurrence rate and operative incision, the excisional range of palmaraponeurosis,contractural extent; To sum up the advantages and disadvantages ofoperative incision and excisional range, and analyze the factors of operativecomplications and recurrence.Methods:From October of2007to August of2014, retrospectively analyze the clinicalcharacteristics, surgical methods, operative complications, and long-termcurative effect of our hospital68cases（94hands） of Dupuytren’s Disease. Theapplication of statistical principle assesses the relation between the operativecomplications, recurrence rate and operative incision, the excisional range ofpalmar aponeurosis, contractural extent of the digital.Results:This group had68cases94hands, including57male,11female. Among them,the ratio of male and female was5.18vs1.The number of patients between50yearsold and59years old was most, accounting for50%, and patients over60years oldaccounted for42.65%,therefore, Dupuytren’s contracture occurs commonly inmiddle-aged and old-age men.The number of left hand was22, right hand22,bilateral26.There are130fingers affected by Dupuytren’s contracture: indexfingers6digital, middle finger13digital, ring finger59digital, littlefingers52digital; a total of ring and little fingers were111digital, accountedfor85.38%, which were the most common. Tubiana staging of Dupuytren s disease: stage N:17hands, stage a:9hands, stage b:12hands, stage ē:21hands, stageⅢ:18hands, stage:17hands.The rate of early postoperative complications was14.89%(14/94).In this group of patients, early composite complications included12hands of10cases, The rate of early composite complications was12.77%(12/94).Among them, the incidence of cutaneous necrosis was10.64%(10/94), skin infectionrate was6.38%(6/94), subcutaneous hematoma occurred in7.45%(7/94), vascularinjury incidence rate was2.13%(2/94), nerve injury rate was3.19%(3/94).Theapplication of statistical principles (SPSS21.0soft-ware) comes to the followingconclusions: subcutaneous hematoma and cutaneous necrosis are related to theexcisional range of palmar aponeurosis （P=0.042，P=0.041），cutaneous necrosisis related to the choice of operative incision （P=0.045），cutaneous necrosis isrelevant to contractural extent of the digital(P=0.035)， recurrences arecorrelated to the excisional range of palmar aponeurosis (P=0.033). Patients werefollowed up for10～64months, average26months. Patients were followed up59patients with80hands. Recurrence occurred in6hands of5cases, the rate ofrecurrence was7.50%.On the basis of evaluation of Dupuytren’s contracture inpost-operative effect of evaluation of Adam: the excellent and good rate was92.50%.Conclusions:Dupuytren’s contracture occurs commonly in middle-aged and old-age men, ringfingers and little fingers are the most commonly involved. Cutaneous necrosis isrelated to the excisional range of palmar aponeurosis(the area of separation) andcontractural extent of the digital,having nothing to do with the choice ofoperative incision; Subcutaneous hematoma is relevant to the excisional range ofpalmar aponeurosis(the area of separation),having nothing to do with the operationincision and contractural extent of the digital; recurrences are correlated tothe excisional range of palmar aponeurosis. The main reason of the recurrence ofDupuytren’s contracture is that excision of the lesion tissue is not complete,thorough resection of the lesion tissue is the key to avoid recurrence. Early operation and careful operation will greatly reduce the incidence of operativecomplications and the recurrence rate of Dupuytren’s Disease...