The epidemiological, etiological, and clinical comparisons of primary and recurrent Dupuytren's contractures.

Abstract

Background: Dupuytren's contracture is characterized by the thickening of the palmar fascia. Although extensive literature exists on this disease, changes in lifestyle necessitate the re-evaluation of its epidemiology, etiology, and clinical features. This study aims to revise the current characteristics of Dupuytren's contracture and to explore potential relationships between these characteristics and recurrence.

Methods: Patients who underwent surgery for Dupuytren's contracture between January 2014 and December 2016 were included in this study. Electronic health records were reviewed to collect data on gender, age at surgery, age at the first signs of the disease, dominant hand, profession, cigarette and alcohol consumption, comorbidities and their treatments, the affected hand and digit, operative technique, type of anesthesia, degree of joint contracture severity, and presence of recurrence. Patients with and without recurrence were compared.

Results: A total of 69 patients were included (60 males, nine females) with a mean age of 68.4 years (range: 51-90 years). Unilateral hand involvement was significantly more common. Recurrence occurred in seven patients (six males, one female). Comparison between patients with and without recurrence revealed that involvement of the first ray was significantly associated with recurrence. Partial palmar fasciectomy was the most commonly performed surgical procedure for recurrence treatment. No other significant differences were observed between the groups. The initial contracture angles of the metacarpophalangeal joints were higher compared to those observed in recurrence, whereas the proximal and distal interphalangeal joints were similar.

Conclusion: No new recurrence-independent epidemiological, etiological, or clinical factors were identified for Dupuytren's contracture. However, first ray involvement was significantly associated with recurrence. Partial palmar fasciectomy was the primary surgical approach for treating recurrence. Metacarpophalangeal recurrence was less severe than the initial disease, while proximal and distal interphalangeal recurrences were similar in severity.