Surgical Treatment for Dupuytren's Contracture

Thirteen hands in twenty one cases with Dupuytren's contracture treated surgically between 1973 and 1994 are reported. Subjects included 18 males and 3 females ranging in age from 34 to 88 years, with a mean of 63.1 years. The duration between onset and surgery ranged from one month to 10 years with an average of 3.7 years. Surgical treatment was performed in 8 cases with the right side affected, 4 with the left and 9 were bilaterally affected. Preoperative grade was classified according to Einarsson's modification of Meyerding's classification. Of the 32 hands, there were no hands of grade 0, 12 hands were grade I, 6 hands were grade II, 13 hands were grade III and 1 hand was grade IV. As to the types of surgical treatment, limited fasciectomy, including z-plasty or skin graft, was performed in 12 hands. The follow-up period lasted from one to 20 years, and averaged 6.4 years.The results were evaluated according to Tubiana's classification. They were very good in 10 hands (31.3%), good in 12 hands (37.5%), fair in 2 hands (6.3%) and poor in 8 hands (25.0%). The clinical results were significantly better in the limited fasciectomy group than in the fasciotomy group.