OUR EXPERIENCE WITH DUPUYTREN'S CONTRACTURE AND PATIENTS PERSPECTIVES USING THE MICHIGAN HAND QUESTIONNAIRE

Background: Dupuytren's disease is a benign proliferative disease of the palmar and digital fascia. Patients with severe contracture and functional disability are operative candidates. Most common treatment modalities employed are regional fasciectomy or dermato fasciectomy. As this disease is relatively uncommon in India, our purpose is to study the disease severity, its underlying associations, and the outcomes after surgery. Methods: A study was done on 46 patients over the last 17 years who presented to our institute. All patients underwent regional fasciectomy or dermato fasciectomy for the deformity and were followed up for a period of 2 years. Michigan Hand Questionnaire scores were calculated for each patient in pre-operative and 6 months post-operative period. Results: Out of the 46 patients operated, 52.17% patients had bilateral hand involvement, 36.95% patients had involvement of right hand exclusively while only 10.86% patients had involvement of left hand alone. 41.3% of the patients whose right hand was operated on belonged to Tubiana Stage 3. Regional fasciectomy with/without grafting was done in 52.17% patients whereas dermato fasciectomy with grafting was done in remaining 47.82% patients. Recurrence was seen in 6.52% of the patients. The Michigan Hand Questionnaire calculated at 6 months showed 20-40% improvement in all stages of Tubiana and maximum improvement was seen with Aesthetics scale. The operative outcome, complications and recurrence rates are comparable to other published s Conclusion: tudies. Regional fasciectomy has proved to be safe and effective in all stages of Tubiana classification.