An Objective Method to Evaluate the Risk of Recurrence and Extension of Dupuytren’s Disease

Abstract

This study was undertaken to assess the influence of the factors related to Dupuytren's diathesis on the rates of recurrence and extension of Dupuytren's disease after surgery. The records of 65 patients who underwent surgery for Dupuytren's disease were retrospectively studied and the presence of factors related to diathesis were recorded. The sensitivity and specificity of each factor for predicting recurrence and extension were calculated. Odds ratios and 95% confidence intervals were also calculated and a discriminant analysis was performed to explore correlations between recurrence and extension and the significant variables. Our results confirmed the prognostic value of diathesis. The results have been used to develop a new scoring system for evaluating the risk of recurrence and extension.

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

“…The variables associated with poorer outcome in this study differ from those identified as contributing to the Dupuytren's diathesis in other studies (Abe et al, 2004;Hindocha et al, 2006;Hueston, 1963). This suggests that those patients whose hand function is worse following surgery may not always be the patients who experience recurrence.…”

“…One randomized controlled trial reported a reoperation rate within 5 years of 33/52 (63%) for aponeurotomy and 4/41 (9%) for fasciectomy . Whereas their reoperation rate for aponeurotomy was two times greater than that in our study, their reoperation rate after fasciectomy was similar to ours (6%) Abe and colleagues investigated the factors associated with reoperation at a mean follow-up of 5 years in a small Japanese population (Abe et al, 2004). They found that the factors in the classical diathesis had prognostic value.…”

β-Catenin Overexpression in Dupuytren's Disease Is Unrelated to Disease Recurrence

“…Dupuytren's diathesis also was evaluated by obtaining a thorough family history and asking about ectopic fibrosis (Ledderhose's plantar fibrosis or Peyronie's penile fibrosis). The individual scores of Abe et al [1] were calculated, with a score greater than 4 representing a high recurrence risk. Attention also was focused on the total number of operations and the most extensive surgical technique used in each patient (Table 1).…”

“…A couple attempts to predict recurrence or extension of Dupuytren's disease (DD) by developing scoring systems such as that of Abe et al [1] have been made, with predictive risk values ranging from 23% to 71% [1,10]. Such risk scores are based on clinical features.…”

“…Parameters for these scoring systems are the personal history of the patient and severity of the contracture [7]. An early age of onset, positive family history, multiple ray involvement, and associated fibrotic disease (plantar or penile fibrosis) are predominant risk factors for DD [1,9,10,15].…”