Surgical Treatment of Dupuytren's Disease by Aponeurectomy (15 Cases)

Abstract

Background: Dupuytren's disease is characterized by fibrosis of the superficial palmar aponeurosis which can lead to a deformation of the fingers in flexum. The main objectives of the treatment of Dupuytren's disease are to reduce the flexion and the associated disability. Objectives: The objective of this study was to investigate the epidemiological and clinical profile of Dupuytren's disease and to analyze the results of the treatment by aponeurectomy in comparison with the data of the literature. Methods: We report a retrospective study of 15 cases of Dupuytren's disease treated by aponeurectomy in the orthopedic trauma department B of the Mohammed VI University Hospital Oujda, Morocco, over a 5-year period from February 2017 to March 2022. Results: The mean age of the patients was 52.6 years and 30% were women. For the risk factors, we found that 56% of the patients have a manual activity, 30% of the patients are diabetics, 17% had a local trauma, 15% are known alcohol consumers, 25% are smokers, 20% of the patients present a similar case in the family. As for the clinic, bilateral forms are found in 60% of cases with a predominance of the 4th ray in both hands. Finally, 67% of our patients were diagnosed in the early stages of the disease (Stage 1, 2, 3 according to the Tubiana classification). Surgical treatment was proposed for 100% of the patients who underwent aponeurectomy with very satisfactory results. Overall, our study allowed us to make findings that are similar to those described in the literature. Conclusion: The genesis of Dupuytren's disease is not yet fully determined despite numerous studies on collagen and fibroblast. Surgery is the most common treatment. The appearance of collagenases, proves to be very interesting for the treatment of palmar forms, but the efficacy and safety of this approach still need to be validated in the medium and long term.

Keywords

• dupuytren
• tubiana
• aponeurectomy