Progression of Dupuytren's Contracture after Partial Fasciectomy

Lee,  Bong Gun; Lee,  Doo Yeon; Lee,  Kwang Hyun

Journal of the Korean Society for Surgery of the Hand 2009;14(2):67-73.
Published online June 1, 2009.

Bong Gun Lee, Doo Yeon Lee, Kwang Hyun Lee

Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Korea. leegh@hanyang.ac.kr

Abstract

Purpose
This study reported the clinical results of partial fasciectomy on Dupuytren's contracture and evaluated the factors associated with progression. MATERIALS AND METHODS: A retrospective analysis was performed on 32 hands in 28 patients who had subtotal fasciectomy for Dupuytren's contracture from 1992 to 2007. We evaluated complications and clinical results by Honner's classification. Through telephone interviews, we checked the progression of contracture including recurrence and extension in twenty three patients with a mean postoperative period of 5.9 years. The relationship between progression and several factors were analyzed using statistical analyses.

Results
Clinical results were excellent in 13 cases, good in 12, fair in 4, and poor in 3. Progression rate was 48% (11patients). It occurred at operated fingers in 3 cases, non-operated fingers in 7 cases and both in 1 case. Progression was correlated with smoking and was more common in patients with bilateral disease, but not with alcohol, age or severity. Complications occurred in 4 patients (1 complex regional pain syndrome, 1 nerve injury and 2 delayed wound healing).

Conclusions
Partial fasciectomy is a suitable method for Dupuytren's contracture. Complication rate is not high if careful operation is performed. However, progression is common in patients with bilateral disease or smoking habitus.