title: Patterns of recontracture after surgical correction of Dupuytren disease.
abstract: OBJECTIVE
  To study the evolution of deformity of the proximal interphalangeal joint over 5 years after good surgical correction of Dupuytren-induced contracture.
  
  
  METHODS
  We assessed 63 patients (72 fingers; 69 hands) with Dupuytren disease for the degree of contracture, its correction after surgery, and the range of movement at the proximal interphalangeal joints at 3 and 6 months, and 1, 3, and 5 years after fasciectomy with or without the use of a firebreak graft. We investigated associations between the recurrence of contracture and preoperative patient and surgical factors.
  
  
  RESULTS
  There were 4 patterns of evolution of contracture after surgical correction. A total of 31 patients (33 hands) showed good improvement that was maintained for 5 years (minimal recontracture group). Twenty patients (23 hands) showed good initial improvement, which mildly worsened (< 20°) but was then maintained over 5 years (mild early recontracture group). Four patients (5 hands) worsened in first 3 months after surgery (> 20°) but there was no further worsening (severe early recontracture group). Eight patients (8 hands) worsened progressively over 5 years (progressive recontracture group). Worsening of contracture more than 6° between 3 and 6 months after surgery predicted progressive recontracture at 5 years.
  
  
  CONCLUSIONS
  Recurrence of contracture (not disease recurrence) could be predicted as early as 6 months after surgery for Dupuytren disease.
authors.affiliation: University Hospitals of Leicester NHS Trust and the Department of Epidemiology, University of Leicester, Leicester, UK.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Dias
authors.forename: Harvinder Pal
authors.initials: HP
authors.lastname: Singh
authors.forename: Aamer
authors.initials: A
authors.lastname: Ullah
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Bhowal
authors.forename: John R
authors.initials: JR
authors.lastname: Thompson
mesh_terms: D004387:Dupuytren Contracture / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012008:Recurrence; D016896:Treatment Outcome
keywords: Disability; Dupuytren disease; deformity; outcome; recurrence