Dupuytren’s Disease - Reasons for Contract in Surgery

Research Article

Austin J Surg. 2019; 6(8): 1178.

Dupuytren’s Disease - Reasons for Contract in Surgery

Bednarek M¹*, Staszkiewicz M², Brudnicki J¹, Koziej M³ and Trybus M²

¹Department of General Surgery, Jagiellonian University Medical College, Poland

²Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of HealthSciences, Jagiellonian University Medical College, Poland

³Cathedral of Anatomy, Jagiellonian University Medical College, Poland

*Corresponding author: Marcin Bednarek, Department of General Surgery, Jagiellonian University Medical College, Poland

Received: March 22, 2019; Accepted: April 05, 2019; Published: April 12, 2019


Dupuytren contracture is one of the most frequently observed fibromatosis. It leads to fibrosis of fascial hand structure. This process causes in consequences fingers contracture and their dysfunction. Nowadays symptomatic treatment including surgical treatment or local application of hyaluronidase is still the only method which can be offered to patients.

The aim of this study was determination of reasons driving patients for Dupuytren contracture treatment. The analysis of correlation between these reasons and subjective assessment of hand function performed on the base of DASH, PEM, HFS questionnaires was done.

The most frequently claimed reason were difficulties in performing of some daily activities, fear concerning progress of the disease and aggravation of finger contracture and looks of the hand. Fear concerning consequences of lack of treatment were also reported.

226 patients (34 female and 192 male) treated due to the Dupuytren contracture in 2nd Department of General Surgery, Jagiellonian University in Cracow were included into this trial.

Statistic correlation between severity of disease and number of reasons for surgical treatment chosen by patients were found. The influence of motivation (number of reasons) on subjective assessment of hand function measured with DASH, HFS and PEM questionnaires was found.

Keywords: Dupuytren’s Disease; Contract Surgery; DASH; HFS; PEM


The progressive process of fibrosis of the fascial structures of the palmar hand surface leads to gradually increasing contracture of fingers [1-12]. The most common procedure is a symptomatic surgical treatment - excision of overgrown strands of the aponeurosis, which allows for the release of contracture, and thus - increases the range of movement of the fingers [1,2,6,7,13]. The predominant reason for the treatment of the affected patients is the contracture of the fingers causing difficulties in certain daily activities [2,6,12,14]. During the surgery eligibility, patients often provided other reasons motivating them to the treatment also. The aim of the study was to answer questions what these reasons are, whether the severity of the disease is an additional motivator for the treatment, and whether other reasons also had an impact on the patients’ subjective assessment of their hand function and on the quality of life of these patients.

Material and Methodology

The study involved 226 patients (34 women and 192 men) treated surgically due to Dupuytren’s contracture in the IInd Department of GeneralSurgery, Jagiellonian University in Cracow between 2006 – 2017y. In 142 patients, pathology was observed bilaterally. The study was focused on affected hand that underwent surgical treatment and usually causing greater ailments for the patient.

After collecting the medical and epidemiological interview, the degree of disease was assessed according to Tubian, Michael and Tomin using a goniometer [15-17]. In the case where the disease included more than one finger, it was assumed that the finger with the largest contracture marks the advancement of the disease process. The effect of Dupuytren’s contracture on the quality of daily activities was assessed using the DASH questionnaire (Disability of the Arm, Shoulder and Hand) and the HFS questionnaire (Hand Function Scoring System), and the impact of this contracture on the quality of life - using the PEM (Patient Evaluation Measure) questionnaire [18- 21]. All patients were asked a question what has prompted them to decide to undergo a surgical treatment. They were left free to choose one or more reasons. The assessment was made of the dependence between the disease progression process and the number of reasons given by the patients for surgery. Furthermore, the relationship between the number of reasons and the results obtained in the study questionnaires DASH, HFS and PEM was assessed. The results were subjected to statistical analysis.


All patients ranged for a surgical treatment received the DASH, HFS and PEM questionnaires to complete. The obtained results of this study are presented in (Table 1).