Dupuytren’s Contracture: Incidence of Injury-Induced Cases and Specific Clinical Expression

Abstract

Background and objectives: Dupuytren’s contracture is a chronic fibroproliferative hand disorder with a varying pattern of genetic predisposition across different regions and populations. Traumatic events have been found to have influence on the development of this illness and are likely to trigger different clinical forms of this disease. The aim of this study was to evaluate the phenomenon of development of Dupuytren’s contracture (DC) following an acute injury to the hand, and to observe the incidence and clinical diversity of such cases in daily clinical practice. Materials and Methods: We collected data of patients presenting with primary Dupuytren’s contracture in the Lithuanian population and evaluated the occurrence and clinical manifestation of this specific type of DC, arising following acute hand trauma. The diagnosis of DC was based on clinical signs and physical examination. Digit contractures were measured by goniometry, and the staging was done according to Tubiana classification. Injury-induced (injury-related) cases were identified using the “Criteria for recognition of Dupuytren’s contracture after acute injury” (established by Elliot and Ragoowansi). Results: 29 (22%) of a total of 132 cases were injury-induced DCs. Twenty-six of 29 patients in this group presented with stage I–II contractures. Duration of symptoms was 6 (SD 2.2) and 3.8 (SD 2.2) years in the injury-related and injury-unrelated DC groups, respectively. Mean age on the onset of symptoms in the injury-induced and non-injury-induced groups was 52 (SD 10.7) and 56 (SD 10.9), respectively. Patients from both groups expressed strong predisposition towards development of DC. Conclusions: Around one-fifth of patients seeking treatment for primary Dupuytren’s contracture seemed to suffer from injury-induced Dupuytren’s contracture. We noted that injury to the wrist and hand seems to trigger the development of less progressive Dupuytren’s contracture in younger age. Prospective randomized studies are required to confirm our findings.

Night time splinting without surgery for dupuytren’s contracture – a successful case series of elderly diabetic patients

“…The response to non invasive therapy was remarkable without any recurrence at short term. The dupuytren's contracture is a fibroproliferative disease, commonly seen in the elderly people and is one of its risk factors (6). The treatment has options with needle injections, and surgery.…”

Effect of extracorporeal shockwave therapy on palmar fibromatosis

“…The earliest posted details and description of the problem was reported in 1614 by Felix Platter, yet it was Guillian Dupuytren who introduced a careful anatomic and obsessive investigation in 1831. What was extraordinary about palmar fibromatosis was that he accentuated the clinical course of the illness, the palmar fibromatosis influencing the hands frequently brings about constraints in aptitude and can fundamentally affect a person's capacity to participate in professional and a vocational exercises [15]. The condition is a significant reason for morbidity which diminishes their personal satisfaction, patients report feeling danger concerns, communicating dread that the fixed flexion of the finger will make it more defenseless to wounds.…”

Sport-Related Traumatic Dupuytren's Contracture

“…Utilizing this criterion, a 2020 study found approximately 20% of their Dupuytren's cases were injury induced (1). Even as the literature on this topic has progressed and diagnostic criteria have been developed, familiarity with this phenomenon seems to be isolated to orthopedic hand specialists.…”

“…Dupuytren's disease is inherited in an autosomal dominant pattern although other associations include age (i.e., older than 50 years), male sex, genetic predisposition (i.e., Northern European origin), alcoholism, human immunodeficiency virus, vascular disease, diabetes mellitus, and epilepsy (1,2). A Dupuytren's contracture progresses through proliferative, involution, and residual phases.…”

“…Only more recently have systematic reviews been performed to demonstrate this connection to the point that this phenomenon is more widely accepted (4). Furthermore, Elliot and Ragoowansi (8) developed a "criteria for recognition of Dupuytren's contracture after acute injury" which includes: Utilizing this criterion, a 2020 study found approximately 20% of their Dupuytren's cases were injury induced (1). Even as the literature on this topic has progressed and diagnostic criteria have been developed, familiarity with this phenomenon seems to be isolated to orthopedic hand specialists.…”