AB0937 Dupuytren's contracture: 15 years of experience with 36 cases

Abstract

Background: Dupuytren's contracture is characterized by thickening and retraction of the palmar aponeurosis due to fibroblastic proliferation leading to progressive and irreducible fingers' flexion. Dupuytren's contracture appears to be a disease with poor clinical symptomatology and the therapeutic progress, in particular the needle aponeurotomy, continues to increase. Objectives: We propose to describe the epidemiological, clinical and therapeutic characteristics- particularly the needle fasciotomy- of Dupuytren's contracture diagnosed and treated in our Rheumatology department. Methods: This is a retrospective descriptive study that collected patients with Dupuytren's disease over a 15-year period from 2001 to 2016. Results: Thirty-six patients were collected. The mean age was 63±10 years (46 years, 83 years) and the sex ratio was 5. 34% of the patients were manual workers, of whom 42% were masons, 25% were farmers and 17% were carpenters. 8% Of longshoremen and 8% of dressmakers. The personal history was diabetes in 63% of cases, of which 26% were unbalanced, hypertension in 31% of cases and hypercholesterolemia in 14% of cases. 6% of patients were epileptic. 23% of patients were ethyl and 13% were smokers. 6% had an associated Leddherhose disease. 9% of our patients had a family history of Dupuytren's disease. The mean time to diagnosis was 60 months [03 months to 180 months]. The clinical examination showed an exclusive involvement of the left hand in 22% of cases, right hand in 12% of cases and bilateral involvement in 66% of cases. The fingers affected were: 59% the ring finger, 49% the little finger, 23% the middle finger, 12% the index and 5.5% the inch, in order of frequency of mention. The stages of Dupuytren's disease at their discovery were as follows: stage 4 (25%), stage 3 (34%), stage 2 (24%) and stage 1 (17%). Skin examination showed that 58% of the skin was inflicted and 42% of the skin was soft. From a therapeutic point of view, 86% of the patients benefited from a needle aponevrotomy with a good progression in 97% and a recurrence in 8% of the cases. In all stages combined, the average postoperative therapeutic gain was 0.83 stage at the Left hand and 1.43 stage at the right. Conclusions: The Dupuytren's contracture is the object of a scientific subject whose wealth grows exponentially. These range from the paternity of his first description, to the place of the last therapeutic modalities.