Document Detail


Surgical management of Dupuytren's contracture in Europe: regional analysis of a surgeon survey and patient chart review.
MedLine Citation:
PMID:  23409695     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
AIM: We explored regional variations in the surgical management of patients with Dupuytren's contracture (DC) in 12 European countries using a surgeon survey and patient chart review.
METHODS: Twelve countries participated: Denmark, Finland, Sweden (Nordic region); Czech Republic, Hungary, Poland (East); France, Germany, the Netherlands, UK (West); Italy, Spain (Mediterranean). For the survey, a random sample of orthopaedic/plastic surgeons (n = 687) with 3-30 years' experience was asked about DC procedures performed during the previous 12 months. For the chart review (n = 3357), information from up to five consecutive patients was extracted. Descriptive statistics are reported.
RESULTS: Ninety-five per cent of all surgeons used fasciectomy for DC, followed by fasciotomy (70%), dermofasciectomy (38%) and percutaneous needle fasciotomy (35%). Most surgeons were satisfied with fasciectomy over other procedures. Recommended time away from work and duration of physical therapy increased with the invasiveness of the procedure. The intra-operative complication rate was 4.0%; the postoperative complication rate was 34%. Overall, ≥ 97% of the procedures were rated by surgeons as having a positive outcome. Across all regions, 54% of patients had no nodules or contracture after the procedures. Only 2% of patients required retreatment within the first year of surgery. Important inter- and intraregional differences in these aspects of patient management are described.
CONCLUSIONS: Understanding current regional treatment patterns and their relationships to country-specific health systems may facilitate earlier identification of, and intervention for, DD and help to optimise the overall treatment for patients with this chronic condition.
Authors:
J Dias; C Bainbridge; C Leclercq; R A Gerber; D Guerin; J C Cappelleri; P P Szczypa; L B Dahlin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of clinical practice     Volume:  67     ISSN:  1742-1241     ISO Abbreviation:  Int. J. Clin. Pract.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9712381     Medline TA:  Int J Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  271-81     Citation Subset:  IM    
Copyright Information:
© 2013 Blackwell Publishing Ltd.
Affiliation:
Musculoskeletal Clinical Business Unit, University Hospitals of Leicester, Leicester, Leicestershire, UK.
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