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AB0937 Dupuytren's contracture: 15 years of experience with 36 cases
  1. H Mouanaa,
  2. M Jguirim,
  3. A Arfa,
  4. A Farhat,
  5. M Brahim,
  6. A Mhenni,
  7. Z Saoussen,
  8. I Bejia,
  9. M Touzi,
  10. N Bergaoui
  1. Rheumatology Unit of the Monastir University Hospital, Monastir, Tunisia

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.

Disclosure of Interest None declared

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