Alencar Fernando Henrique Uchôa de, Perini Jamila Alessandra, Monteiro Anderson Vieira, Duarte Maria Eugenia Leite, Motta Geraldo da Rocha, Guimarães João Antônio Matheus
Centro de Cirurgia da Mão, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brasil.
Divisão de Pesquisa, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Aug;56(4):478-484. doi: 10.1055/s-0040-1721839. Epub 2021 Mar 22.
To describe the epidemiological and clinical profile of patients with Dupuytren disease treated by selective fasciectomy and the factors associated with the severity of the disease. Retrospective descriptive observational study involving 247 patients with Dupuytren disease, from 2013 to 2019. Multivariate logistic regression was performed for data analysis. Most patients were male (83.8%), self-declared white (65.2%), alcoholics (59.6%) and 49% were smokers, with a mean age of 66 ± 9 years old, with 77.2% presenting symptoms of the disease after the age of 51 years old. Approximately 51.9, 29.6 and 17.3%, respectively, had arterial hypertension, diabetes mellitus and dyslipidemia comorbidities. Bilateral involvement of the hands was observed in 73.3% of the patients. The rate of intra- and post-selective fasciectomy complications was of 0.6 and 24.3%, respectively, with 5.2% of the patients needing reintervention after 1 year of follow-up. After multivariate analysis, males were associated with bilateral involvement of the hands (odds ratio [OR] = 2.10; 95% confidence interval [CI]: 1.03-4.31) and with a greater number of affected rays (OR = 3.41; 95% CI: 1.66-7.03). Dyslipidemia was associated with reintervention (OR = 5.7; 95% CI = 1.03-31.4) and bilaterality with a higher number of complications (35.7 versus 19.7%). A low rate of reintervention and operative complications was observed in patients with Dupuytren disease treated by selective fasciectomy. Male gender was associated with severe disease (bilaterality and more than two affected rays), and dyslipidemia with reintervention.
描述接受选择性筋膜切除术治疗的掌腱膜挛缩症患者的流行病学和临床特征，以及与疾病严重程度相关的因素。 2013年至2019年，对247例掌腱膜挛缩症患者进行回顾性描述性观察研究。采用多因素逻辑回归进行数据分析。 大多数患者为男性（83.8%），自称白人（65.2%），酗酒者（59.6%），49%为吸烟者，平均年龄66±9岁，77.2%在51岁后出现疾病症状。分别约有51.9%、29.6%和17.3%的患者合并动脉高血压、糖尿病和血脂异常。73.3%的患者双手受累。选择性筋膜切除术中及术后并发症发生率分别为0.6%和24.3%，5.2%的患者在随访1年后需要再次干预。多因素分析后，男性与双手受累（优势比[OR]=2.10；95%置信区间[CI]：1.03-4.31）以及更多受累指（OR=3.41；95%CI：1.66-7.03）相关。血脂异常与再次干预相关（OR=5.7；95%CI=1.03-31.4），双手受累且并发症较多（35.7%对19.7%）。 接受选择性筋膜切除术治疗的掌腱膜挛缩症患者再次干预和手术并发症发生率较低。男性与严重疾病（双手受累和两个以上受累指）相关，血脂异常与再次干预相关。
