title: Surgical management of Dupuytren's contracture in Europe: regional analysis of a surgeon survey and patient chart review.
abstract: OBJECTIVE
  We explored regional variations in the surgical management of patients with Dupuytren's contracture (DC) in 12 European countries using a surgeon survey and patient chart review.
  
  
  METHODS
  Twelve countries participated: Denmark, Finland, Sweden (Nordic region); Czech Republic, Hungary, Poland (East); France, Germany, the Netherlands, UK (West); Italy, Spain (Mediterranean). For the survey, a random sample of orthopaedic/plastic surgeons (n = 687) with 3-30 years' experience was asked about DC procedures performed during the previous 12 months. For the chart review (n = 3357), information from up to five consecutive patients was extracted. Descriptive statistics are reported.
  
  
  RESULTS
  Ninety-five per cent of all surgeons used fasciectomy for DC, followed by fasciotomy (70%), dermofasciectomy (38%) and percutaneous needle fasciotomy (35%). Most surgeons were satisfied with fasciectomy over other procedures. Recommended time away from work and duration of physical therapy increased with the invasiveness of the procedure. The intra-operative complication rate was 4.0%; the postoperative complication rate was 34%. Overall, ≥ 97% of the procedures were rated by surgeons as having a positive outcome. Across all regions, 54% of patients had no nodules or contracture after the procedures. Only 2% of patients required retreatment within the first year of surgery. Important inter- and intraregional differences in these aspects of patient management are described.
  
  
  CONCLUSIONS
  Understanding current regional treatment patterns and their relationships to country-specific health systems may facilitate earlier identification of, and intervention for, DD and help to optimise the overall treatment for patients with this chronic condition.
authors: Musculoskeletal Clinical Business Unit, University Hospitals of Leicester, Leicester, Leicestershire, UK. jd96@le.ac.uk
authors: J
authors: J
authors: Dias
authors: C
authors: C
authors: Bainbridge
authors: C
authors: C
authors: Leclercq
authors: R A
authors: RA
authors: Gerber
authors: D
authors: D
authors: Guerin
authors: J C
authors: JC
authors: Cappelleri
authors: P P
authors: PP
authors: Szczypa
authors: L B
authors: LB
authors: Dahlin
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D015331:Cohort Studies; D004387:Dupuytren Contracture / Q000601:surgery*; D005060:Europe; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data; D018582:Sick Leave / Q000706:statistics & numerical data; D013518:Surgery, Plastic / Q000706:statistics & numerical data