title: Dupuytren contracture recurrence project: reaching consensus on a definition of recurrence.
abstract: The aim of this study was to determine a definition of recurrence of Dupuytren disease that could be utilized for the comparison of the results independently from the treatment used. 24 hand surgeons from 17 countries met in an international consensus conference. The participants used the Delphi method to evaluate a series of statements: (1) the need for defining recurrence, (2) the concept of recurrence applied to the Tubiana staging system, (3) the concept of recurrence applied to each single treated joint, and (4) the concept of recurrence applied to the finger ray. For each item, the possible answer was given on a scale of 1-5: 1=maximum disagreement; 2=disagreement; 3=agreement; 4=strong agreement; 5=absolute agreement. There was consensus on disagreement if 1 and 2 comprised at least 66% of the recorded answers and consensus on agreement if 3, 4 and 5 comprised at least 66% of the recorded answers. If a threshold of 66% was not reached, the related statement was considered "not defined". A need for a definition of recurrence was established. The presence of nodules or cords without finger contracture was not considered an indication of recurrence. The Tubiana staging system was considered inappropriate for reporting recurrence. Recurrence was best determined by the measurement of a specific joint, rather than a total ray. Time 0 occurred between 6 weeks and 3 months. Recurrence was defined as a PED of more than 20° for at least one of treated joint, in the presence of a palpable cord, compared to the result obtained at time 0. This study determined the need for a standard definition of recurrence and reached consensus on that definition, which we should become the standard for the reporting of recurrence. If utilized in subsequent publications, this will allow surgeons to compare different techniques and make is easier to help patients make an informed choice.
authors.affiliation: Direttore ad interim UOC Chirurgia Plastica e Chirurgie della Mano A.O.R.N. "San Camillo-Forlanini" Roma - Italy.
authors.forename: N
authors.initials: N
authors.lastname: Felici
authors.affiliation: Instituto Clinico Città di Bressica, Unità Operativa di Chirurgia della Mano e Microchirurgia Ortopedica, Brescia - Italy.
authors.forename: I
authors.initials: I
authors.lastname: Marcoccio
authors.affiliation: Chefarzt der Handchirurgie, Plastische Chirurgie und Ästhetische Chirurgie, Campus Innenstadt und Grosshadern der Ludwig-Maximilians Universität München - Germany.
authors.forename: R
authors.initials: R
authors.lastname: Giunta
authors.affiliation: Head of Department, Plastic and Hand Surgery, Orthopaedic Clinic, Markgroeningen(Stuttgart) - Germany.
authors.forename: M
authors.initials: M
authors.lastname: Haerle
authors.affiliation: Institut de la Main Clinique Jouvenet, Paris - France.
authors.forename: C
authors.initials: C
authors.lastname: Leclercq
authors.affiliation: Director Of Hand Surgery Department - St. Joseph Hospital MultiMedica Group Milan - Italy Plastic Surgery School - University of Milan Italy.
authors.forename: G
authors.initials: G
authors.lastname: Pajardi
authors.affiliation: Senior Consultant Department of Hand Surgery Akademiska University Hospital, Uppsala.
authors.forename: S
authors.initials: S
authors.lastname: Wilbrand
authors.affiliation: Professor in Plastic Surgery and Reconstructive Microsurgery University of Medicine Iuliu Hatieganu Spitalul Clinic de Recuperare Clinic of Plastic Surgery and Reconstructive Microsurgery.
authors.forename: A V
authors.initials: AV
authors.lastname: Georgescu
authors.affiliation: Chief, Central Jersey Hand Surgery, Eatontown, NJ Clinical Senior Instructor, Department of Orthopedic Surgery, Drexel University School of Medicine, Philadelphia, PA.
authors.forename: G
authors.initials: G
authors.lastname: Pess
mesh_terms: D003697:Delphi Technique; D004387:Dupuytren Contracture / Q000145:classification* / Q000175:diagnosis / Q000601:surgery*; D005385:Fingers / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000145:classification* / Q000175:diagnosis*; D012008:Recurrence