Prognosis of long-term postoperative complications after surgical treatment of dupuytren’s disease (Contracture)

Abstract

© RJPT All right reserved. Background Dupuytren’s disease (DD) is a proliferative fibromatosis of the hand, which causes permanent flexion contracture of the digits and, ultimately, loss of function. The treatment of DD is complex and involves surgical and nonsurgical approaches, with the goal of removing the affected tissue. Systems analysis of postoperative complications depending on combination of factors of the patient and influencing development of long-term postoperative complications (LPC) is the way which can optimize tactics of surgical treatment. Purpose To develop prognosis of long-term postoperative complications’ technology after surgical treatment of Dupuytren’s disease (contracture) on the basis of the analysis of A-factors, determining the biological status of the patient (gender, age, terms of disease, examination period, grade of lesion by DD, heredity, accompanying diseases, surgical history and traumas, the disease beginning, laboratory analyses, etc.); B-factors, presenting life style of the patient (residence, physical and mental job, bad habits, etc.); C-factors, presenting technical-surgical components of operations and rehabilitational treatment (the experience of the surgeon, types of operations, anaesthesia, section, dermal plasty, rehabilitational treatment, healing, etc.). Methods Anamnesis, operative measures, postoperative catamnesis, mathematical modeling. Results Technology allows to prognosticate the operation outcome in 58,9–81,4% of cases. This depends on type of considered factors (a combination of factors,% of prognosticated cases): 1. A + B + C 72,8–78,7% (р=0,0001) 2. A+В 64,4–73,3% (р=0,0001); 3. C 58,9–81,4% (р ≤ 0,002). Conclusions Anamnesis, the analysis of technique of operative measures and rehabilitational treatment allow to predict the outcome of operative treatment concerning DD. Increasing (27 factors) and decreasing (12 factors) of LPC are the outstanding points for development prognosis of LPC.