Queen Margaret Hospital, Dunfermline, UK.
Edinburgh Orthopaedics, University of Edinburgh and Royal Infirmary of Edinburgh, UK.
J Hand Surg Asian Pac Vol. 2022 Jun;27(3):453-458. doi: 10.1142/S2424835522500473.
The aims of this study were to investigate the impact of diabetes mellitus on patient-reported functional outcome measures (PROMs) and satisfaction following surgical treatment of Dupuytren contracture. Preoperative and 1-year postoperative PROMs were collected prospectively over 6 years (2013-2019). Patients completed the QuickDASH score and were asked 'how normal is your hand?', recording responses on a 100-point visual analogue scale. Patient satisfaction was also self-reported. Paired responses were available for 520 hands (478 patients; 72% follow-up rate). There were 62 patients with diabetes (12%). Pre (12.5 vs. 9.1; = 0.01) and postoperative (11.4 vs. 6.8; = 0.02) QuickDASH scores were significantly, but not clinically, worse in diabetic patients. Patient satisfaction was high in both groups. A large and significant improvement in self-perceived hand normality was observed in both groups ( < 0.05). No significant differences were observed in preoperative or change in hand normality between the groups, but the postoperative normal hand score was significantly higher in non-diabetic patients (94 vs. 90; = 0.02). Our study has demonstrated statistically significantly worse disability in diabetic patients with Dupuytren contracture both pre- and postoperatively, though the observed differences were far below the minimum clinically important difference for the QuickDASH. Both groups reported a large and statistically significant improvement in self-perceived hand normality following surgery. Level III (Therapeutic).
本研究旨在探讨糖尿病对接受手术治疗的掌腱膜挛缩患者的报告患者功能结局测量（PROMs）和满意度的影响。在 6 年期间（2013-2019 年）前瞻性收集了术前和术后 1 年的 PROMs。患者完成了 QuickDASH 评分，并被问到“您的手有多正常？”，使用 100 分视觉模拟量表记录回答。患者满意度也由患者自行报告。为 520 只手（478 名患者；72%的随访率）提供了配对反应。有 62 名患者患有糖尿病（12%）。糖尿病患者的术前（12.5 比 9.1； = 0.01）和术后（11.4 比 6.8； = 0.02）QuickDASH 评分明显但无临床意义地较差。两组患者的满意度均较高。两组患者的自我感知手正常程度均有较大且显著的改善（ < 0.05）。术前或手正常程度的变化在两组之间无显著差异，但非糖尿病患者的术后正常手评分显著更高（94 比 90； = 0.02）。我们的研究表明，患有掌腱膜挛缩的糖尿病患者术前和术后的残疾程度均明显统计学显著，但观察到的差异远低于 QuickDASH 的最小临床重要差异。两组患者在手术后均报告了自我感知手正常程度的较大且统计学显著的改善。III 级（治疗）。
