Nationwide rates of limited fasciectomy for Dupuytren’s contracture: data from the Finnish National Registry
DOI:
https://doi.org/10.2340/jphs.v60.40569Keywords:
Dupuytren’s disease, Dupuytren’s contracture, limited fasciectomy, limited aponeurectomy, incidence, nationwide ratesAbstract
Dupuytren’s contracture (DC) is often treated with limited fasciectomy (LF), while percutaneous treatment options are gaining popularity. The recent trends in the incidence rates of LF are not well known. Our study aimed to investigate the incidence rates of LF over time, and we collected nationwide data on all LF performed between January 1, 1997 and December 31, 2018.
The main outcome variables were the incidence rates of first and subsequent LF for each patient per 100,000 person-years, calculated for each study year, gender, and age group. Data were obtained from the Finnish National Hospital Discharge Registry, which covers the entire population of Finland. Reporting to the registry is mandatory for all public and private hospitals, and the validity has been found to be excellent. All adult patients with a diagnosis code of M72.0 for DC and a surgical procedure code of NDM10 for LF were included in this study.
The incidence rate of the first LF declined from 36.5 to 11.7, while the rate of subsequent LF increased from 2.3 to 14.0 from 1997 to 2011 and then declined to 9.3 in 2018. LF was performed significantly more often in men than in women (ratio 4:1). Additionally, it was performed significantly more often in patients between 60 and 79 years than in other age groups.
Despite the estimated increase in the prevalence of DC, our data show that the incidence rate of first LF has declined, and there was no discernible consistent trend in the incidence of subsequent LF during the same period.
Downloads
References
McFarlane RM. Patterns of the diseased fascia in the fingers in Dupuytren’s contracture. Displacement of the neurovascular bundle. Plast Reconstr Surg. 1974;54(1):31–44. https://doi.org/10.1097/00006534-197407000-00004 DOI: https://doi.org/10.1097/00006534-197407000-00004
Lanting R, Broekstra DC, Werker PM, et al. A systematic review and meta-analysis on the prevalence of Dupuytren disease in the general population of Western countries. Plast Reconstr Surg. 014;133(3):593–603. https://doi.org/10.1097/01.prs.0000438455.37604.0f DOI: https://doi.org/10.1097/01.prs.0000438455.37604.0f
Brenner P, Mailänder P, Berger A. Epidemiology of Dupuytren’s disease. In: Berger A, Delbrück A, Brenner P, Hinzmann R, editors. Dupuytren’s disease: pathobiochemistry and clinical management. Berlin, Heidelberg: Springer Berlin Heidelberg; 1994. p. 244–254.
Salari N, Heydari M, Hassanabadi M, et al. The worldwide prevalence of the Dupuytren disease: a comprehensive systematic review and meta-analysis. J Orthop Surg Res. 2020;15(1):495. https://doi.org/10.1186/s13018-020-01999-7 DOI: https://doi.org/10.1186/s13018-020-01999-7
Bebbington E, Furniss D. Linear regression analysis of Hospital Episode Statistics predicts a large increase in demand for elective hand surgery in England. J Plast Reconstr Aesthet Surg. 2015;68(2):243–251. https://doi.org/10.1016/j.bjps.2014.10.011 DOI: https://doi.org/10.1016/j.bjps.2014.10.011
Trojian TH, Chu SM. Dupuytren’s disease: diagnosis and treatment. Am Fam Physician. 2007 Jul 1;76(1):86–89. DOI: https://doi.org/10.2106/00004623-200701000-00026
Engstrand C, Krevers B, Nylander G, et al. Hand function and quality of life before and after fasciectomy for Dupuytren contracture. J Hand Surg Am. 2014 Jul;39(7):1333.e2–1343.e2. https://doi.org/10.1016/j.jhsa.2014.04.029 DOI: https://doi.org/10.1016/j.jhsa.2014.04.029
Ball C, Izadi D, Verjee LS, et al. Systematic review of non-surgical treatments for early Dupuytren’s disease. BMC Musculoskelet Disord. 2016 Aug 15;17(1):345. https://doi.org/10.1186/s12891-016-1200-y DOI: https://doi.org/10.1186/s12891-016-1200-y
Desai SS, Hentz VR. The treatment of Dupuytren disease. J Hand Surg Am. 2011 May;36(5):936–942. https://doi.org/10.1016/j.jhsa.2011.03.002 DOI: https://doi.org/10.1016/j.jhsa.2011.03.002
Weinzweig N, Culver JE, Fleegler EJ. Severe contractures of the proximal interphalangeal joint in Dupuytren’s disease: combined fasciectomy with capsuloligamentous release versus fasciectomy alone. Plast Reconstr Surg. 1996;97(3):560–567. https://doi.org/10.1097/00006534-199603000-00011 DOI: https://doi.org/10.1097/00006534-199603000-00011
Jerosch-Herold C, Shepstone L, Chojnowski AJ, et al. Night-time splinting after fasciectomy or dermo-fasciectomy for Dupuytren’s contracture: a pragmatic, multi-centre, randomised controlled trial. BMC Musculoskelet Disord. 2011;12(1):136. https://doi.org/10.1186/1471-2474-12-136 DOI: https://doi.org/10.1186/1471-2474-12-136
Hurst LC, Badalamente MA, Hentz VR, et al. Injectable collagenase clostridium histolyticum for Dupuytren’s contracture. N Engl J Med. 2009;361(10):968–979. https://doi.org/10.1056/NEJMoa0810866 DOI: https://doi.org/10.1056/NEJMoa0810866
Strömberg J. Percutaneous needle fasciotomy for Dupuytren contracture. JBJS Essent Surg Tech. 2019 Mar 26;9(1):e6. https://doi.org/10.2106/JBJS.ST.18.00047 DOI: https://doi.org/10.2106/JBJS.ST.18.00047
Duquette S, Kuster R, Evans T, et al. Treatment of Dupuytren contracture with injectable collagenase within the veterans affairs system. JAMA Surg. 2017 Feb 1;152(2):204–205. https://doi.org/10.1001/jamasurg.2016.3605 DOI: https://doi.org/10.1001/jamasurg.2016.3605
Zhao JZ, Hadley S, Floyd E, et al. The impact of collagenase clostridium histolyticum introduction on dupuytren treatment patterns in the United States. J Hand Surg. 2016;41(10):963–968. https://doi.org/10.1016/j.jhsa.2016.07.090 DOI: https://doi.org/10.1016/j.jhsa.2016.07.090
Dias J, Tharmanathan P, Arundel C, et al. Collagenase Injection versus limited fasciectomy for Dupuytren’s Contracture. N Engl J Med. 2024 Oct 24;391(16):1499–1510. https://doi.org/10.1056/NEJMoa2312631 DOI: https://doi.org/10.1056/NEJMoa2312631
Räisänen MP, Leppänen OV, Soikkeli J, et al. Surgery, needle fasciotomy, or collagenase injection for Dupuytren Contracture: a randomized controlled trial. Ann Intern Med. 2024 Mar;177(3):280–290. https://doi.org/10.7326/M23-1485 DOI: https://doi.org/10.7326/M23-1485
van Rijssen AL, ter Linden H, Werker PM. Five-year results of a randomized clinical trial on treatment in Dupuytren’s disease: percutaneous needle fasciotomy versus limited fasciectomy. Plast Reconstr Surg. 2012;129(2):469–477. https://doi.org/10.1097/PRS.0b013e31823aea95 DOI: https://doi.org/10.1097/PRS.0b013e31823aea95
Byström M, Ibsen Sörensen A, et al. Five-year results of a randomized, controlled trial of collagenase treatment compared with needle fasciotomy for Dupuytren contracture. J Hand Surg Am. 2022 Mar;47(3):211–217. https://doi.org/10.1016/j.jhsa.2021.11.019 DOI: https://doi.org/10.1016/j.jhsa.2021.11.019
Werker PM, Pess GM, van Rijssen AL, et al. Correction of contracture and recurrence rates of Dupuytren contracture following invasive treatment: the importance of clear definitions. J Hand Surg Am. 2012;37(10):2095.e7–2105.e7. https://doi.org/10.1016/j.jhsa.2012.06.032 DOI: https://doi.org/10.1016/j.jhsa.2012.06.032
Vandenbroucke JP, von Elm E, Altman DG, et al, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Ann Intern Med. 2007 Oct 16;147(8):W163–W194. https://doi.org/10.7326/0003-4819-147-8-200710160-00010-w1 DOI: https://doi.org/10.7326/0003-4819-147-8-200710160-00010-w1
Mattila VM, Sillanpaa P, Iivonen T, et al. Coverage and accuracy of diagnosis of cruciate ligament injury in the Finnish National Hospital Discharge Register. Injury. 2008;39(12):1373–1376. https://doi.org/10.1016/j.injury.2008.05.007 DOI: https://doi.org/10.1016/j.injury.2008.05.007
Huttunen TT, Kannus P, Pihlajamaki H, et al. Pertrochanteric fracture of the femur in the Finnish National Hospital Discharge Register: validity of procedural coding, external cause for injury and diagnosis. BMC Musculoskelet Disord. 2014;15:98. https://doi.org/10.1186/1471-2474-15-98 DOI: https://doi.org/10.1186/1471-2474-15-98
World Health Organization. International statistical classification of diseases and related health problems [Internet]. 10th revision, Fifth edition, 2016. ICD-10. Geneva: World Health Organization; 2015. Available from: https://apps.who.int/iris/handle/10665/246208
Nomesco N. NOMESCO Classification of Surgical Procedures (NCSP), version 1.16. In 2009. Available from: https://api.semanticscholar.org/CorpusID:78459301
Zhang D, Earp BE, Blazar P. Collagenase treatment versus needle fasciotomy for single-digit Dupuytren Contractures: a meta-analysis of randomized controlled trials. J Hand Surg Am. 2023 Dec;48(12):1200–1209. https://doi.org/10.1016/j.jhsa.2023.08.008 DOI: https://doi.org/10.1016/j.jhsa.2023.08.008
Alhebshi ZA, Bamuqabel AO, Alqurain Z, et al. Comparing complications and patient satisfaction following injectable collagenase versus limited fasciectomy for Dupuytren’s disease: a systematic review and meta-analysis. Cureus. 2024 Jan;16(1):e53147. https://doi.org/10.7759/cureus.53147 DOI: https://doi.org/10.7759/cureus.53147
Fitzpatrick AV, Moltaji S, Ramji M, et al. Systematic review comparing cost analyses of fasciectomy, needle aponeurotomy, and collagenase injection for treatment of Dupuytren’s Contracture: une analyse de coûts systématique comparant la fasciectomie, l’aponévrotomie percutanée à l’aiguille et l’injection de collagénase pou traiter la maladie de Dupuytren. Plast Surg (Oakv). 2021 Nov;29(4):257–264. https://doi.org/10.1177/2292550320963111 DOI: https://doi.org/10.1177/2292550320963111
van Rijssen AL, Gerbrandy FS, Ter Linden H, et al. A comparison of the direct outcomes of percutaneous needle fasciotomy and limited fasciectomy for Dupuytren’s disease: a 6-week follow-up study. J Hand Surg Am. 2006;31(5):717–725. https://doi.org/10.1016/j.jhsa.2006.02.021 DOI: https://doi.org/10.1016/j.jhsa.2006.02.021
Gerber RA, Perry R, Thompson R, et al. Dupuytren’s contracture: a retrospective database analysis to assess clinical management and costs in England. BMC Musculoskelet Disord. 2011;12:73. https://doi.org/10.1186/1471-2474-12-73 DOI: https://doi.org/10.1186/1471-2474-12-73
Maravic M, Lasbleiz S, Roulot E, et al. Hospitalization for Dupuytren’s disease: a French national descriptive analysis, 2002 to 2009. Orthop Traumatol Surg Res. 2014;100(6):589–592. https://doi.org/10.1016/j.otsr.2014.05.013 DOI: https://doi.org/10.1016/j.otsr.2014.05.013
Nordenskjöld J, Englund M, Zhou C, et al. Prevalence and incidence of doctor-diagnosed Dupuytren’s disease: a population-based study. J Hand Surg Eur Vol. 2017;42(7):673–677. https://doi.org/10.1177/1753193416687914 DOI: https://doi.org/10.1177/1753193416687914
Guğmundsson KG, Arngrímsson R, Sigfússon N, et al. Prevalence of joint complaints amongst individuals with Dupuytren’s disease – from the Reykjavík study. Scand J Rheumatol. 1999;28(5):300–304. https://doi.org/10.1080/03009749950155481 DOI: https://doi.org/10.1080/03009749950155481
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mikko Räisänen, Teemu Valtteri Karjalainen, Tuomas Tapani Huttunen, Ville Matti Mattila, Aleksi Rafael Reito, Olli Ville Leppänen, Janne Johannes Soikkeli, Jarkko Juhani Jokihaara
This work is licensed under a Creative Commons Attribution 4.0 International License.
Acta Chirurgica Scandinavica Society owns the copyright for all material published until Volume 57 (2023) unless otherwise specified. As from 2024 all published articles, unless otherwise specified, are published under CC-BY licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, with the condition of proper attribution to the original work.
