Surgical management of Dupuytren's contracture in Europe: regional analysis of a surgeon survey and patient chart review. Issue 3 (15th February 2013)

• Record Type: Journal Article
• Authors: Dias, J.; Bainbridge, C.; Leclercq, C.; Gerber, R. A.; Guerin, D.; Cappelleri, J. C.; Szczypa, P. P.; Dahlin, L. B.
• Is Part Of: International journal of clinical practice. Volume 67:Issue 3(2013)
• Page Start: 271
• Page End: 281
• Publication Date: 2013-02-15
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12106
• Languages: English
• ISSNs: 1368-5031

Abstract

<abstract abstract-type="main" xml:lang="en" id="ijcp12106-abs-0001"> <title>Summary</title> <sec id="ijcp12106-sec-0001" sec-type="section"> <title>Aim</title> <p>We explored regional variations in the surgical management of patients with Dupuytren's contracture (DC) in 12 European countries using a surgeon survey and patient chart review.</p> </sec> <sec id="ijcp12106-sec-0002" sec-type="section"> <title>Methods</title> <p>Twelve countries participated: Denmark, Finland, Sweden (Nordic region); Czech Republic, Hungary, Poland (East); France, Germany, the Netherlands, UK (West); Italy, Spain (Mediterranean). For the survey, a random sample of orthopaedic/plastic surgeons (<italic>n </italic>= 687) with 3–30 years' experience was asked about DC procedures performed during the previous 12 months. For the chart review (<italic>n </italic>= 3357), information from up to five consecutive patients was extracted. Descriptive statistics are reported.</p> </sec> <sec id="ijcp12106-sec-0003" sec-type="section"> <title>Results</title> <p>Ninety‐five per cent of all surgeons used fasciectomy for DC, followed by fasciotomy (70%), dermofasciectomy (38%) and percutaneous needle fasciotomy (35%). Most surgeons were satisfied with fasciectomy over other procedures. Recommended time away from work and duration of physical therapy increased with the invasiveness of the procedure. The intra‐operative complication rate was 4.0%; the postoperative complication rate was 34%. Overall, ≥ 97% of the procedures were rated by surgeons as having a positive outcome. Across all regions, 54% of patients had no nodules or contracture after the procedures. Only 2% of patients required retreatment within the first year of surgery. Important inter‐ and intraregional differences in these aspects of patient management are described.</p> </sec> <sec id="ijcp12106-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Understanding current regional treatment patterns and their relationships to country‐specific health systems may facilitate earlier identification of, and intervention for, DD and help to optimise the overall treatment for patients with this chronic condition.</p> </sec> </abstract>