Epidemiology of Dupuytren disease and Patients Undergoing Selective Fasciectomy / Epidemiologia da doença de Dupuytren e de pacientes submetidos a fasciectomia seletiva

Abstract Objective To describe the epidemiological and clinical profile of patients with Dupuytren disease treated by selective fasciectomy and the factors associated with the severity of the disease. Methods Retrospective descriptive observational study involving 247 patients with Dupuytren disease, from 2013 to 2019. Multivariate logistic regression was performed for data analysis. Results Most patients were male (83.8%), self-declared white (65.2%), alcoholics (59.6%) and 49% were smokers, with a mean age of 66 ± 9 years old, with 77.2% presenting symptoms of the disease after the age of 51 years old. Approximately 51.9, 29.6 and 17.3%, respectively, had arterial hypertension, diabetes mellitus and dyslipidemia comorbidities. Bilateral involvement of the hands was observed in 73.3% of the patients. The rate of intra- and post-selective fasciectomy complications was of 0.6 and 24.3%, respectively, with 5.2% of the patients needing reintervention after 1 year of follow-up. After multivariate analysis, males were associated with bilateral involvement of the hands (odds ratio [OR] = 2.10; 95% confidence interval [CI]: 1.03-4.31) and with a greater number of affected rays (OR = 3.41; 95% CI: 1.66-7.03). Dyslipidemia was associated with reintervention (OR = 5.7; 95% CI = 1.03-31.4) and bilaterality with a higher number of complications (35.7 versus 19.7%). Conclusion A low rate of reintervention and operative complications was observed in patients with Dupuytren disease treated by selective fasciectomy. Male gender was associated with severe disease (bilaterality and more than two affected rays), and dyslipidemia with reintervention.

Resumo Objetivo Descrever o perfil epidemiológico e clínico dos pacientes com doença de Dupuytren tratados por fasciectomia seletiva e os fatores associados com a gravidade da doença. Metodologia Estudo observacional descritivo retrospectivo envolvendo 247 pacientes com doença de Dupuytren, no período de 2013 a 2019. Foi realizada regressão logística multivariada para análise dos dados. Resultados A maioria dos pacientes era do sexo masculino (83,8%), autodeclarados brancos (65,2%), etilistas (59,6%), e 49% eram tabagistas. A média de idade foi de 66 ± 9 anos, sendo que 77,2% apresentaram os sintomas da doença após os 51 anos. Aproximadamente 51,9, 29,6, e 17,3%, respectivamente, apresentaram hipertensão arterial, diabetes mellitus e dislipidemia. O acometimento bilateral das mãos foi observado em 73,3% dos pacientes. A taxa de complicações intra- e pós-fasciectomia seletiva foi de 0,6 e 24,3%, respectivamente, sendo que 5,2% dos pacientes necessitaram de reintervenção após 1 ano de acompanhamento. Após análise multivariada, o sexo masculino foi associado com acometimento bilateral das mãos (odds ratio [OR] = 2,10; intervalo de confiança [IC] 95%: 1,03-4,31) e com maior número de raios acometidos (OR = 3,41; IC 95%: 1,66-7,03). A dislipidemia foi associada com a reintervenção (OR = 5,7; CI 95%: 1,03-31,4) e a bilateralidade com maior número de complicações (35,7% versus 19,7%). Conclusão Foi observada uma baixa taxa de reintervenção e complicações operatórias nos pacientes com doença de Dupuytren tratados por fasciectomia seletiva. O sexo masculino foi associado com o quadro grave da doença (bilateralidade e mais de dois raios acometidos), e a dislipidemia com a reintervenção.

Epidemiological analysis of patients with Dupuytren's disease / Análise epidemiológica dos pacientes com doença de Dupuytren

ABSTRACT Objective: To evaluate the risk factors and analyze the characteristics of patients and lesions in Dupuytren's disease. Methods: Retrospective analysis of patients diagnosed with Dupuytren's disease in a hand surgery clinic in 2013. The authors evaluated parameters associated with the patient profiles and risk factors, the form and severity of involvement, and characteristics of the lesions. Results: 58 patients were evaluated, totaling 79 hands, with bilateral involvement in 46% of cases. The involvement of the ulnar fingers of the hand represented 78%, 44% being the ring finger. In 55% of cases, the patients had cords, while 45% showed only nodules. As for related factors, they were found most commonly in men (55%), whites (93%), and the elderly. Of coexisting diseases, the following were present: diabetes mellitus (49%), especially in the insulin-dependent (62%), hypertension (55.2%), and dyslipidemia (19%). With regard to lifestyle, 22% were smokers and 9% were alcohol consumers. Conclusion: It was observed a higher incidence of Dupuytren's disease was observed among men, whites, and the ulnar fingers of the hand, especially the ring finger. The most common associated diseases were diabetes mellitus and hypertension.

RESUMO Objetivo: Avaliar os fatores de risco e analisar as características dos pacientes e das lesões encontradas em portadores da doença de Dupuytren. Métodos: Análise retrospectiva dos pacientes diagnosticados com a doença de Dupuytren no ambulatório de cirurgia da mão em 2013. Foram avaliados parâmetros associados ao perfil dos pacientes e fatores de risco, a forma e gravidade do acometimento e as características das lesões. Resultados: Foram avaliados 58 pacientes, 79 mãos, com acometimento bilateral em 46% dos casos. O envolvimento dos dedos do lado ulnar da mão representou 78%, 44% dos casos no dedo anular. Em 55% dos casos os pacientes apresentavam cordas, enquanto 45% mostravam apenas nódulos. Quanto aos fatores relacionados, encontramos predomínio em homens (55%), brancos (93%) e idosos. Das doenças coexistentes, estavam presentes a diabetes mellitus (49%), especialmente nos insulinodependentes (62%), hipertensos (55,2%) e dislipidêmicos (19%). Com relação aos hábitos de vida, 22% eram fumantes e 9% etilistas. Conclusão: Foi observada uma maior incidência da doença de Dupuytren entre homens, brancos, nos dedos do lado ulnar da mão, principalmente no dedo anular. As doenças mais comumente associadas foram o diabetes mellitus e hipertensão arterial sistêmica.

The Epidemiology of Dupuytren's Disease in Korea: a Nationwide Population-based Study

BACKGROUND: To date, there have been few reports on the nationwide population-based epidemiology of Dupuytren's disease (DD). We investigated the prevalence and incidence of DD in Korea using the large dataset provided by the Korean Health Insurance Review and Assessment Service. This study is the second nationwide epidemiological study of DD after the study in Taiwan. METHODS: Records of patients diagnosed with DD between 2007 and 2014 were extracted from the large dataset by diagnostic code searching (International Classification of Disease 10th revision code M72.0) and were included in the study. We calculated the prevalence and incidence of DD based on the total population of Korea provided by the Korean Statistical Information Service. Diseases associated with DD and the trends in surgery for DD were also analyzed. RESULTS: A total 16,630 patients were diagnosed with DD during the study period. The mean annual prevalence was 32.2 per 100,000 population (41.8 per 100,000 for men; 22.5 per 100,000 for women). The mean annual incidence was 1.09 per 100,000 population (1.80 per 100,000 for men; 0.38 per 100,000 for women). The common diseases associated with DD were hypertension (30.5%), diabetes mellitus (26.7%), hyperlipidemia (20.4%), ischemic heart disease (7.9%), and cerebrovascular disease (4.6%). The mean annual proportion of the patients who had surgery for DD was 5.24% of all DD patients. CONCLUSION: The prevalence and incidence of DD in Korea were 100–1,000 times lower than those in western countries; however, it was slightly larger than that in Taiwan.

A Case of Palmar Fibromatosis / 대한피부과학회지

No abstract available.

Enfermedad de Dupuytren en un anciano / Dupuytren's disease in an elderly

Se describe el caso clínico de un comerciante de 78 años de edad, de procedencia haitiana, quien presentaba, desde hacía 7 meses, rigidez al flexionar la articulación interfalángica proximal y medial del cuarto dedo de la mano izquierda, contractura de la aponeurosis palmar y nódulos. Se le realizó fasciectomía parcial o subtotal y egresó a las 72 horas con buena evolución posoperatoria.

The case report of a 78-year-old Haitian merchant is described, who had stifness to flex the proximal and medial interphalangeal joint of the left hand fourth finger for seven months, contracture of the palmar fascia and nodules. He underwent partial or subtotal fasciectomy and was discharged within 72 hours with good postoperative course.

Clinical characteristics and Effect of Partial Fasciectomy in Dupuytren's Disease of the Korean / 대한정형외과학회잡지

From January 1982 to December 1991, we experienced 96 hands of 66 patients with Dupuytren's disease in Seoul National University Hospital. We performed retrospective analysis of these 96 hands of 66 patients and the results were as follows. Among 66 patients, 60 patients (91%) were male and 51 patients (77%) were in sixth or seventh decade, the average age 58.1 years. Occupations of 66 patients were manual laborer(18 patients, 28%), farmer(15 patients, 22%), sportsman(4 patients, 6%) and deskworker(29 patients, 44%). Among the diseases such as diabetes mellitus, alcoholics, epilepsy known as associated with Dupuytren's disease, diabetes mellitus was more common in our cases, whereas alcoholics and epilepsy were relatively rare. There was no case in which family history was present. Both hands were involved in 30 patients, right hand only in 30 patients, and left hand only in 6 patients. Right hand was involved in 60 patients(91%), whereas left hand was involved in 36 patients(55%). The case in which only the 4th finger was involved was most common(42 hands, 44%). The 4th finger was affected most frequently(81 hands, 84%). In diabetic patients, the middle finger was involved more frequently than in non-diabetic patients(p < 0.05). Most of patients(83 hands, 86%) had symptoms of flexion contracture, nodule or contracted cord simultaneously. Surgical treatment was per- formed in 32 hands of 22 patients, with the results of excellent in 24 hands(75%), good in 6 hands(19%) and no recurrence, in average follow-up 3.6 years(2.6 years to 5.0 years). In conclusion, it might be thought that Dupuytren's disease in which surgical treatment was required was relatively rare in Korean and even if necessary, partial fasciectomy resulted in rather good result.

A Clinical Study of Dupuytren Disease / 대한정형외과학회잡지

We experienced the 17 hands of 11 patients with Dupuytren disease, which was known as relatively rare in orientals. Retrospectively, we analyse it and the results were followings; l. Among 11 patients, 10 patients were male and average age was 62.5 years (49 to 77 years) 2. Most (15 hands, 88%) of patients had symptoms of flexion contracture, nodule and contracted cord, simultaneously. 3. Occupation of patients was agricultural laborer in 9 patients (82%). 4. In 9 patients(82%); individual habit of alcoholic drinking, more than 3 times per week, and smoking, 1 package per day, over 20 years more, was observed. 5. In 15 hands (88%), ulnar side of fingers (4th+5th, 5th only or 3rd+4th+5th)was involved. 6. Surgical treatment was performed in 9 hands of 7 patients, with results of excellent in 6 hands (67%) and no recurrence, in average follow up 2.6 years (1.5 year to 3.7 year)