Comparative Clinical and Pathomorphological Characteristics of Dupuytren’s Contracture in Men and Women

Abstract

Background. The data available in the literature on the features of the clinical course and functional prognosis of Dupuytren`s disease in women is contradictory, there are no data on comparative pathomorphological studies of palmar fibromatosis in men and women.The aim of the study was to identify possible differences in the clinical and pathomorphological characteristics of Dupuytren`s disease in men and women.Materials and Methods. 228 cases of men and 39 women (6:1) who underwent fasciectomy in 2013–2019 period were analyzed. Histomorphometry of paraffin sections of the patient`s palmar fascia specimens of 24 men and 24 women was performed.Results. Men ranged in age from 26 to 83, the median age is 3 years more in women (p<0.001), but the median age of Dupuytren`s disease debut is 2 years less in women (p<0.001). The frequency of contractures of the 3rd–4th degree was 35.9% in the group of women and 65% in the group of men (p<0.001). In the group of women the frequency of both hands involvement is 15.2% higher, I–III fingers involvement is 8.7% higher, recurrent contracture is 11.1% higher (p<0.1). Histomorphometric analysis of the patient`s palmar fascia specimens showed that women compared to men had 10.23% less adipose tissue (p<0.001), 7.87% less dense connective tissue (p<0.05), but the proportion of hyperplastic connective tissue was 20.31% higher.Conclusion. Dupuytren`s disease is less common in women, than men. Women seek surgical treatment earlier than men. The tendency to functional limitations intensification and the risk of recurrence in women is associated with higher expression of hyperplastic changes in the fascial structures of the hand.