Abstract:
Introduction. Dupuytren's disease (M 72.0) is a fibroproliferative disorder, a disease of the
conjuctive system of unknown etiology, which often leads to shortening and thickening of the
palmar and digital fascia, to a permanent and irreversible flexion of the fingers. Dupuytren's
contracture mainly affects the ring finger and pinky, and occurs most often in older men of
Northern European descent.
Aim of the study. The retrospective and prospective analysis of the surgical treatment results of
MD through various surgical methods.
Materials and methods. During 2013-2017, in department of Hand Surgery with the application
of microsurgical techniques in Clinical Hospital of Traumatology and Orthopedics, at 426
patients (361 (84.7%) men and 65 (15.2%) women) Dupuytren's disease was diagnosed and
treated with different surgical techniques. The mean age for men was 57.3 years and for women
59.6 years, mean age for both - 58.5 years. Urban patients - 156 (36.7%), rural - 270 (63.3%).
The number of patients that had their right hand operated was 246 (57.7%) and the left hand -
180 (42.3%). The most commonly affected finger was finger IV – 129 patients (51.19%); finger
V - 92 patients (36.51%); III - 22 (8.73%); I - 8 (3.17%); II - 1 (0.4%). III degree of Dupuytren
disease was found in 343 (81%) patients, II degree at 60 (14%) and IV degree in 23 (5.4%)
patients. In most cases (289 patients) selective excision of palmar aponeurosis with Z-plasty was
performed; in 37 cases percutaneous needle aponeurotomy (PNA) was performed; in 13 patients
- the open palm technique (from Mc Cash 1964); in 12 patients - cross finger skin flap; in 3 cases
- radial forearm flap and in 2 cases – the amputation of pinky finger
Results. In order to evaluate the patient's condition and the function of the pre- and postoperative
upper limb the DASH subjective inquiry "Disability of the Arm, Shoulder and Hand
Outcome Measure" was used.
Conclusions. Regardless of the successes in the treatment of orthopedic diseases and experience
in the treatment of the serious forms of Dupuytren diseas, the issue of the treatment of these
patients remains current. Surgical treatment can correct contractions, but the issue of recurrences
and enlargements of the disease remains unresolved.
