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Morbidity of interventions in previously untreated Dupuytren disease: A systematic review

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Abstract

Treatment morbidity in previously untreated, or primary, Dupuytren disease has limited representation in the literature. Despite the clinical importance of stratifying risk of intervention based on treatment history, most articles addressing management complications pool both primary and recurrent disease. The aim of this systematic review was to quantify interventional morbidity in primary Dupuytren disease only and isolate the complication profiles of established interventions in previously untreated patients. A literature search was conducted using keywords on Medline and bibliographic linkage. Excluded papers did not address primary Dupuytren disease complications or did not include separate, primary-only complication data. Rates of morbidity were calculated from pooled data extracted from the included studies. Thirty-five papers met the criteria for inclusion. The review has quantified that open procedures carry higher complication rates than closed in the context of primary Dupuytren disease treatment. Amongst closed procedures, the only rate of skin split was high. It is noteworthy that this review has identified the limited isolated primary disease complication data available in the literature, which should prompt further targeted research. This systematic review addresses quantification of complication rates following treatment of primary Dupuytren disease and demonstrates that open interventions carry greater morbidity than closed. Whilst this study highlights the need for a future investigation, the complication data presented should nonetheless facilitate informed decision-making for clinicians and patients when considering initial treatments for primary Dupuytren disease.

Level of Evidence: Level IV, therapeutic study.

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References

  1. Becker GW, Davis TR (2010) The outcome of surgical treatments for primary Dupuytren’s disease--a systematic review. J Hand Surg Eur Vol 35(8):623–626

    Article  CAS  PubMed  Google Scholar 

  2. Chen NC, Srinivasan RC, Shauver MJ, Chung KC (2011) A systematic review of outcomes of fasciotomy, aponeurotomy, and collagenase treatments for Dupuytren’s contracture. Hand 6(3):250–255

    Article  PubMed  PubMed Central  Google Scholar 

  3. Kadhum M, Smock E, Khan A, Fleming A (2017) Radiotherapy in Dupuytren’s disease: a systematic review of the evidence. J Hand Surg Eur 42(7):689–692

    Article  CAS  Google Scholar 

  4. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535

    Article  PubMed  PubMed Central  Google Scholar 

  5. Pess GM, Pess RM, Pess RA (2012) Results of needle aponeurotomy for Dupuytren contracture in over 1,000 fingers. J Hand Surg Am 37(4):651–656

    Article  PubMed  Google Scholar 

  6. van Rijssen AL, Gerbrandy FS, Ter Linden H, Klip H, Werker PM (2006) A comparison of the direct outcomes of percutaneous needle fasciotomy and limited fasciectomy for Dupuytren’s disease: a 6-week follow-up study. J Hand Surg Am 31(5):717–725

    Article  PubMed  Google Scholar 

  7. Herrera FA, Mitchell S, Elzik M, Roostaeian J, Benhaim P (2015) Modified percutaneous needle aponeurotomy for the treatment of Dupuytren’s contracture: early results and complications. Hand 10(3):433–437

    Article  PubMed  PubMed Central  Google Scholar 

  8. Toppi JT, Trompf L, Smoll NR, Lim V, Smith K, Findlay MW, Hunter-Smith DJ (2015) Dupuytren’s contracture: an analysis of outcomes of percutaneous needle fasciotomy versus open fasciectomy. ANZ J Surg 85(9):639–643

    Article  PubMed  Google Scholar 

  9. Scherman P, Jenmalm P, Dahlin LB (2016) One-year results of needle fasciotomy and collagenase injection in treatment of Dupuytren’s contracture: a two-centre prospective randomized clinical trial. J Hand Surg Eur 41(6):577–582

    Article  CAS  Google Scholar 

  10. Molenkamp S, Schouten TA, Broekstra DC, Werker PM, Moolenburgh JD (2017) Early post-operative results of percutaneous needle fasciotomy in 451 patients with Dupuytren disease. Plast Reconstr Surg 13:1415–1421

    Article  CAS  Google Scholar 

  11. Clibbon JJ, Logan AM (2001) Palmar segmental aponeurectomy for Dupuytren’s disease with metacarpophalangeal flexion contracture. J Hand Surg Br 26(4):360–361

    Article  CAS  PubMed  Google Scholar 

  12. Denkler K (2005) Dupuytren’s fasciectomies in 60 consecutive digits using lidocaine with epinephrine and no tourniquet. Plast Reconstr Surg 115(3):802–810

    Article  CAS  PubMed  Google Scholar 

  13. Skoff HD (2004) The surgical treatment of Dupuytren’s contracture: a synthesis of techniques. Plast Reconstr Surg 113(2):540–544

    Article  PubMed  Google Scholar 

  14. Coert JH, Nerin JP, Meek MF (2006) Results of partial fasciectomy for Dupuytren disease in 261 consecutive patients. Ann Plast Surg 57(1):13–17

    Article  CAS  PubMed  Google Scholar 

  15. Ali SN, McMurtrie A, Rayatt S, Roberts JO (2006) Ulnar-based skin flap for Dupuytren’s fasciectomy. Scand J Plast Reconstr Surg Hand Surg 40(5):307–310

    Article  PubMed  Google Scholar 

  16. Misra A, Jain A, Ghazanfar R, Johnston T, Nanchahal J (2007) Predicting the outcome of surgery for the proximal interphalangeal joint in Dupuytren’s disease. J Hand Surg Am 32(2):240–245

    Article  PubMed  Google Scholar 

  17. Sorene ED, Rubinraut-Ophir E, Goodwin DR (2007) Dupuytren’s disease in Oriental Jews. J Hand Surg Eur 32(5):543–546

    Article  CAS  Google Scholar 

  18. Mavrogenis AF, Spyridonos SG, Ignatiadis IA, Antonopoulos D, Papagelopoulos PJ (2009) Partial fasciectomy for Dupuytren’s contractures. J Surg Orthop Adv 18(2):106–110

    PubMed  Google Scholar 

  19. Donaldson OW, Pearson D, Reynolds R, Bhatia RK (2010) The association between intraoperative correction of Dupuytren’s disease and residual postoperative contracture. J Hand Surg Eur Vol 35(3):220–223

    Article  CAS  PubMed  Google Scholar 

  20. Uemura T, Kazuki K, Egi T, Yoneda M, Takamatsu K, Nakamura H (2010) Clinical outcomes of primary skin closure with Y-V and Z-plasties for Dupuytren’s contracture: use of one-stage skin closure. J Plast Surg Hand Surg 44(6):306–310

    Article  PubMed  Google Scholar 

  21. Chan W-C, Wan S-H, Ip F-K (2012) Review of partial fasciectomy for Dupuytren’s contracture in southern Chinese patients. J Orthop Trauma Rehabil 16(2):51–54

    Article  Google Scholar 

  22. Kan HJ, Selles RW, van Nieuwenhoven CA, Zhou C, Khouri RK, Hovius SE (2016) Percutaneous aponeurotomy and lipofilling (PALF) versus limited fasciectomy in patients with primary Dupuytren’s contracture: a prospective, randomized, controlled trial. Plast Reconstr Surg 137(6):1800–1812

    Article  CAS  PubMed  Google Scholar 

  23. Abe Y, Rokkaku T, Kuniyoshi K, Matsudo T, Yamada T (2007) Clinical results of dermofasciectomy for Dupuytren’s disease in Japanese patients. J Hand Surg Eur Vol 32(4):407–410

    Article  CAS  PubMed  Google Scholar 

  24. McMillan C, Binhammer P (2012) Steroid injection and needle aponeurotomy for Dupuytren contracture: a randomized, controlled study. J Hand Surg Am 37(7):1307–1312

    Article  PubMed  Google Scholar 

  25. Citron ND, Nunez V (2005) Recurrence after surgery for Dupuytren’s disease: a randomized trial of two skin incisions. J Hand Surg Br 30(6):563–566

    Article  CAS  PubMed  Google Scholar 

  26. Stahl S, Calif E (2008) Dupuytren’s palmar contracture in women. Isr Med Assoc J 10(6):445–447

    PubMed  Google Scholar 

  27. Tate R, Mackay D, Broome G (2011) A prospective study of limited palmar and digital fasciectomy under local anaesthetic wrist block and upper arm tourniquet. J Hand Surg Eur 36 (9):811–812. doi:

  28. Pereira A, Massada M, Sousa R, Silva C, Trigueiros M, Lemos R (2012) Percutaneous needle fasciotomy in Dupuytren’s contracture: is it a viable technique? Acta Orthop Belg 78(1):30–34

    PubMed  Google Scholar 

  29. van Rijssen AL, Werker PM (2006) Percutaneous needle fasciotomy in Dupuytren’s disease. J Hand Surg Br 31(5):498–501

    Article  PubMed  Google Scholar 

  30. Denkler K (2010) Surgical complications associated with fasciectomy for Dupuytren’s disease: a 20-year review of the English literature. Eplasty 10:e15

    PubMed  PubMed Central  Google Scholar 

  31. Gilpin D, Coleman S, Hall S, Houston A, Karrasch J, Jones N (2010) Injectable collagenase Clostridium histolyticum: a new nonsurgical treatment for Dupuytren’s disease. J Hand Surg Am 35(12):2027–2038.e2021

    Article  PubMed  Google Scholar 

  32. Badalamente MA, Hurst LC (2000) Enzyme injection as nonsurgical treatment of Dupuytren’s disease. J Hand Surg Am 25(4):629–636

    Article  CAS  PubMed  Google Scholar 

  33. Considine S, Heaney R, Hirpara KM (2015) Early results of the use of collagenase in the treatment of Dupuytren’s contracture. Ir J Med Sci 184(2):323–327

    Article  CAS  PubMed  Google Scholar 

  34. Grandizio LC, Akoon A, Heimbach J, Graham J, Klena JC (2017) The use of residual collagenase for single digits with multiple-joint Dupuytren contractures. J Hand Surg Am 2017:04

    Google Scholar 

  35. Badalamente MA, Hurst LC, Hentz VR (2002) Collagen as a clinical target: nonoperative treatment of Dupuytren’s disease. J Hand Surg Am 27(5):788–798

    Article  PubMed  Google Scholar 

  36. Hurst LC, Badalamente MA, Hentz VR, Hotchkiss RN, Kaplan FT, Meals RA, Smith TM, Rodzvilla J, Group CIS (2009) Injectable collagenase clostridium histolyticum for Dupuytren’s contracture. N Engl J Med 361(10):968–979

    Article  CAS  PubMed  Google Scholar 

  37. Peimer CA, Blazar P, Coleman S, Kaplan FT, Smith T, Lindau T (2015) Dupuytren contracture recurrence following treatment with collagenase Clostridium histolyticum (CORDLESS [collagenase option for reduction of Dupuytren long-term evaluation of safety study]): 5-year data. J Hand Surg Am 40(8):1597–1605

    Article  PubMed  Google Scholar 

  38. Tubiana R (1975) Planning of surgical treatment. Hand 7(3):223–227

    Article  CAS  PubMed  Google Scholar 

  39. Zhou C, Hovius SE, Slijper HP, Feitz R, Van Nieuwenhoven CA, Pieters AJ, Selles RW (2015) Collagenase Clostridium histolyticum versus limited fasciectomy for Dupuytren’s contracture: outcomes from a multicenter propensity score matched study. Plast Reconstr Surg 136(1):87–97

    Article  CAS  PubMed  Google Scholar 

  40. Paynter J, Tobin V, Rozen W, Hunter-Smith D (2018) Dupuytren’s disease and collagenase: evidence for a paradigm shift in management. Aust J Plast Surg 1(2)

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Author notes

  1. Rachael Leung and Robert Capstick contributed equally to this work.

Authors and Affiliations

  1. Department of Plastic, Reconstructive and Hand Surgery, Frankston Hospital, Peninsula Health, PO Box 52, Frankston, Victoria, 3199, Australia

    Rachael Leung, Robert Capstick, Angela Lei, David Nour, Warren M. Rozen & David J. Hunter-Smith

  2. Peninsula Clinical School, Central Clinical School at Monash University, The Alfred Centre, 99 Commercial Rd, Melbourne, Victoria, 3004, Australia

    Rachael Leung, Robert Capstick, Angela Lei, David Nour, Warren M. Rozen & David J. Hunter-Smith

  3. Department of Surgery, School of Clinical Sciences at Monash University, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria, 3168, Australia

    Warren M. Rozen & David J. Hunter-Smith

Authors
  1. Rachael Leung
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  2. Robert Capstick
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  3. Angela Lei
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  4. David Nour
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Correspondence to David J. Hunter-Smith.

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The authors received no financial support for the research, authorship and/or publication of this article.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of interest

Rachael Leung, Robert Capstick, Angela Lei, David Nour, Warren Rozen and David Hunter-Smith declare that they have no conflict of interest.

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Leung, R., Capstick, R., Lei, A. et al. Morbidity of interventions in previously untreated Dupuytren disease: A systematic review. Eur J Plast Surg 42, 111–118 (2019). https://doi.org/10.1007/s00238-018-1490-4

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  • DOI: https://doi.org/10.1007/s00238-018-1490-4

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