Purpose To study the evolution of deformity of the proximal interphalangeal joint over 5 years after good surgical correction of Dupuytren-induced contracture. Methods We assessed 63 patients (72 fingers; 69 hands) with Dupuytren disease for the degree of contracture, its correction after surgery, and the range of movement at the proximal interphalangeal joints at 3 and 6 months, and 1, 3, and 5 years after fasciectomy with or without the use of a firebreak graft. We investigated associations between the recurrence of contracture and preoperative patient and surgical factors. Results There were 4 patterns of evolution of contracture after surgical correction. A total of 31 patients (33 hands) showed good improvement that was maintained for 5 years (minimal recontracture group). 20 patients (23 hands) showed good initial improvement, which mildly worsened (≤20°) but was then maintained over 5 years (mild early recontracture group). 4 patients (5 hands) worsened in first 3 months after surgery (>20°) but there was no further worsening (severe early recontracture group). 8 patients (8 hands) worsened progressively over 5 years (progressive recontracture group). Worsening of contracture more than 6° between 3 and 6 months after surgery predicted progressive recontracture at 5 years. Conclusions Recurrence of contracture (not disease recurrence) could be predicted as early as 6 months after surgery for Dupuytren disease.
Copyright remains with the authors and publisher.
Purpose To study the evolution of deformity of the proximal interphalangeal joint over 5 years after good surgical correction of Dupuytren-induced contracture. Methods We assessed 63 patients (72 fingers; 69 hands) with Dupuytren disease for the degree of contracture, its correction after surgery, and the range of movement at the proximal interphalangeal joints at 3 and 6 months, and 1, 3, and 5 years after fasciectomy with or without the use of a firebreak graft. We investigated associations between the recurrence of contracture and preoperative patient and surgical factors. Results There were 4 patterns of evolution of contracture after surgical correction. A total of 31 patients (33 hands) showed good improvement that was maintained for 5 years (minimal recontracture group). 20 patients (23 hands) showed good initial improvement, which mildly worsened (≤20°) but was then maintained over 5 years (mild early recontracture group). 4 patients (5 hands) worsened in first 3 months after surgery (>20°) but there was no further worsening (severe early recontracture group). 8 patients (8 hands) worsened progressively over 5 years (progressive recontracture group). Worsening of contracture more than 6° between 3 and 6 months after surgery predicted progressive recontracture at 5 years. Conclusions Recurrence of contracture (not disease recurrence) could be predicted as early as 6 months after surgery for Dupuytren disease.
Copyright remains with the authors and publisher.