Skip to main content
Top
Published in: HAND 2/2008

01-06-2008 | Original Article

Revised Tubiana’s Staging System for Assessment of Disease Severity in Dupuytren’s Disease—Preliminary Clinical Findings

Authors: Sandip Hindocha, John K. Stanley, James Stewart Watson, Ardeshir Bayat

Published in: HAND | Issue 2/2008

Login to get access

Abstract

There are few objective staging systems to assess severity of Dupuytren’s disease (DD). Previous methods to assess severity of DD were based primarily on the degree of contracture of an affected digit measured using a goniometer. Nonetheless, this method of assessment alone may be incomplete, and other factors should be considered. White (n = 92) patients diagnosed with DD from northwest of England were assessed for DD. Objective criteria for evaluating severity incorporated quantified variables. The revised severity stage was correlated to a known staging system of DD (Tubiana’s staging system) which measures total flexion deformity for a single affected digit. Total revised severity staging scores ranged between 4 and 53 (mean = 18.7) and revealed significant positive correlation to Tubiana’s original staging system (r 2 = 0.8, p < 0.001). There was significant difference between severity staging scores in those with a positive family history compared to those without (p < 0.01). In current practice, often, the degree of contracture in an affected digit is used solely as a measure of disease severity. Additional objective clinical information may provide useful prognostic indices for disease progression as well as postoperative outcome.
Literature
1.
go back to reference Abe Y, Rokkaku S, Ofuchi S, Tokunaga S, Takahashi K, Moriya H. An objective method to evaluate the risk of recurrence and extension of Dupuytren’s disease. J Hand Surg (Br) 2004;29-B(5):427–30. Abe Y, Rokkaku S, Ofuchi S, Tokunaga S, Takahashi K, Moriya H. An objective method to evaluate the risk of recurrence and extension of Dupuytren’s disease. J Hand Surg (Br) 2004;29-B(5):427–30.
2.
go back to reference Abe Y, Rokkaku S, Ofuchi S, Tokunaga S, Takahashi K, Moriya H. Surgery for Dupuytren’s disease in Japanese patients and a new preoperative classification. J Hand Surg (Br) 2004;29-B(3):233–7. Abe Y, Rokkaku S, Ofuchi S, Tokunaga S, Takahashi K, Moriya H. Surgery for Dupuytren’s disease in Japanese patients and a new preoperative classification. J Hand Surg (Br) 2004;29-B(3):233–7.
3.
go back to reference Arafa M, Steingold RF, Noble J. The incidence of Dupuytren’s disease in patients with rheumatoid arthritis. J Hand Surg (Br) 1984;9-B:165–6. Arafa M, Steingold RF, Noble J. The incidence of Dupuytren’s disease in patients with rheumatoid arthritis. J Hand Surg (Br) 1984;9-B:165–6.
4.
go back to reference Arkkila PE, Kantola IM, Viikari JS, Ronnemaa T, Vahatalo MA. Dupuytren’s disease in type I diabetic patients: a five year prospective study. Clin Exp Rheumatol 1996;14:59–65.PubMed Arkkila PE, Kantola IM, Viikari JS, Ronnemaa T, Vahatalo MA. Dupuytren’s disease in type I diabetic patients: a five year prospective study. Clin Exp Rheumatol 1996;14:59–65.PubMed
5.
go back to reference Arkkila PE, Kantola IM, Viikari JS. Dupuytren’s disease: association with chronic diabetic complications. J Rheumatol 1997;24:153–9.PubMed Arkkila PE, Kantola IM, Viikari JS. Dupuytren’s disease: association with chronic diabetic complications. J Rheumatol 1997;24:153–9.PubMed
6.
go back to reference Bayat A, McGrouther DA. Management of Dupuytren’s disease—clear advice for an elusive condition. Ann R Coll Surg Engl 2006;88(1):3–8.PubMedCrossRef Bayat A, McGrouther DA. Management of Dupuytren’s disease—clear advice for an elusive condition. Ann R Coll Surg Engl 2006;88(1):3–8.PubMedCrossRef
7.
go back to reference Bonnici AV, Birjandi F, Spencer JD, Fox SP, Berry AC. Chromosomal abnormalities in Dupuytren’s contracture and carpal tunnel syndrome. J Hand Surg (Br) 1992;17(3):349–55. Bonnici AV, Birjandi F, Spencer JD, Fox SP, Berry AC. Chromosomal abnormalities in Dupuytren’s contracture and carpal tunnel syndrome. J Hand Surg (Br) 1992;17(3):349–55.
8.
go back to reference Burge P, Hoy G, Regan P, Milne R. Smoking, alcohol and the risk of Dupuytren’s contracture. J Bone Jt Surg 1997;79-B(2):206–10.CrossRef Burge P, Hoy G, Regan P, Milne R. Smoking, alcohol and the risk of Dupuytren’s contracture. J Bone Jt Surg 1997;79-B(2):206–10.CrossRef
9.
go back to reference de la Caffiniere JY, Wagner R, Etscheid J, Metzger F. Manual labor and Dupuytren’s disease. The results of a computerized survey in the field of iron metallurgy. Ann Chir Main 1983;2(1):66–72.PubMedCrossRef de la Caffiniere JY, Wagner R, Etscheid J, Metzger F. Manual labor and Dupuytren’s disease. The results of a computerized survey in the field of iron metallurgy. Ann Chir Main 1983;2(1):66–72.PubMedCrossRef
10.
go back to reference Draviaraj KP, Chakrabarti I. Functional outcome after surgery for Dupuytren’s contracture: a prospective study. J Hand Surg (Am) 2004;29-A(5):804–8.CrossRef Draviaraj KP, Chakrabarti I. Functional outcome after surgery for Dupuytren’s contracture: a prospective study. J Hand Surg (Am) 2004;29-A(5):804–8.CrossRef
11.
go back to reference Early PF. Population studies in Dupuytren’s contracture. J Bone Jt Surg 1962;44-B(3):602–13. Early PF. Population studies in Dupuytren’s contracture. J Bone Jt Surg 1962;44-B(3):602–13.
12.
go back to reference Hayton MJ, Gray ICM. Dupuytren’s contracture: a review. Curr Orthop 2003;17:1–7.CrossRef Hayton MJ, Gray ICM. Dupuytren’s contracture: a review. Curr Orthop 2003;17:1–7.CrossRef
13.
go back to reference Hindocha S, John S, Stanley JK, Watson SJ, Bayat A. The heritability of Dupuytren’s disease: familial aggregation and its clinical significance. J Hand Surg (Am) 2006;31(2):204–10.CrossRef Hindocha S, John S, Stanley JK, Watson SJ, Bayat A. The heritability of Dupuytren’s disease: familial aggregation and its clinical significance. J Hand Surg (Am) 2006;31(2):204–10.CrossRef
14.
go back to reference Hindocha S, Stanley JK, Watson SJ, Bayat A. Dupuytren’s diathesis—evaluation of prognostic indicators for risk of disease recurrence. J Hand Surg (Am) 2006;31(10):204–10.CrossRef Hindocha S, Stanley JK, Watson SJ, Bayat A. Dupuytren’s diathesis—evaluation of prognostic indicators for risk of disease recurrence. J Hand Surg (Am) 2006;31(10):204–10.CrossRef
15.
go back to reference Hueston JT. Dupuytren’s contracture. Edinburgh & London: E&S Livingstone; 1963: p. 51–120. Hueston JT. Dupuytren’s contracture. Edinburgh & London: E&S Livingstone; 1963: p. 51–120.
16.
go back to reference Kotsis SV, Chung KC. Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities if the Arm, Shoulder and Hand Questionnaire in carpal tunnel surgery. J Hand Surg (Am) 2005;30(1):81–6.CrossRef Kotsis SV, Chung KC. Responsiveness of the Michigan Hand Outcomes Questionnaire and the Disabilities if the Arm, Shoulder and Hand Questionnaire in carpal tunnel surgery. J Hand Surg (Am) 2005;30(1):81–6.CrossRef
17.
go back to reference Kotsis SV, Lau FH, Chung KC. Responsiveness of the Michigan Hand Outcomes Questionnaire and physical measurements in outcome studies of distal radius fracture treatment. J Hand Surg (Am) 2007;32(1):84–90.CrossRef Kotsis SV, Lau FH, Chung KC. Responsiveness of the Michigan Hand Outcomes Questionnaire and physical measurements in outcome studies of distal radius fracture treatment. J Hand Surg (Am) 2007;32(1):84–90.CrossRef
18.
go back to reference Lettin AW. Dupuytren’s diathesis. J Bone Jt Surg (Br) 1964;46-B(2):220–4. Lettin AW. Dupuytren’s diathesis. J Bone Jt Surg (Br) 1964;46-B(2):220–4.
19.
go back to reference McFarlane RM. Dupuytren’s disease: relation to work and injury. J Hand Surg (Am) 1991;16:775–9.CrossRef McFarlane RM. Dupuytren’s disease: relation to work and injury. J Hand Surg (Am) 1991;16:775–9.CrossRef
20.
go back to reference Meyerding HW. Dupuytren’s contracture. Arch Surg 1936;32:320–33. Meyerding HW. Dupuytren’s contracture. Arch Surg 1936;32:320–33.
21.
go back to reference Mikkelsen OA. Dupuytren’s disease—initial symptoms, age of onset and spontaneous course. Hand 1977;9(1):11–15.PubMedCrossRef Mikkelsen OA. Dupuytren’s disease—initial symptoms, age of onset and spontaneous course. Hand 1977;9(1):11–15.PubMedCrossRef
22.
go back to reference Mussy-Westropp N, Krishnan J, Ahern M. Comparing the AUSCAN osteoarthritis hand index, Michigan Hand Outcomes Questionnaire and sequential occupational dexterity assessment for patients with rheumatoid arthritis. J Rheumatol 2004;31(10):1996–2001. Mussy-Westropp N, Krishnan J, Ahern M. Comparing the AUSCAN osteoarthritis hand index, Michigan Hand Outcomes Questionnaire and sequential occupational dexterity assessment for patients with rheumatoid arthritis. J Rheumatol 2004;31(10):1996–2001.
23.
go back to reference Noble J, Arafa M, Royle SG, McGeorgeG, Crank S. The association between alcohol, hepatic pathology and Dupuytren’s disease. J Hand Surg (Br) 1992;17-B:71–4. Noble J, Arafa M, Royle SG, McGeorgeG, Crank S. The association between alcohol, hepatic pathology and Dupuytren’s disease. J Hand Surg (Br) 1992;17-B:71–4.
24.
go back to reference Reilly RM, Stern PJ, Goldfarb CA. A retrospective review of the management of Dupuytren’s nodules. J Hand Surg (Am) 2005;30-A(5):1014–1018.CrossRef Reilly RM, Stern PJ, Goldfarb CA. A retrospective review of the management of Dupuytren’s nodules. J Hand Surg (Am) 2005;30-A(5):1014–1018.CrossRef
25.
go back to reference Skoog T. Dupuytren’s contracture with special reference to aetiology and improved surgical treatment, its occurrence in epileptics, note on Knuckle pads. Acta Chir Scand 1948;96(Suppl 39):25–175. Skoog T. Dupuytren’s contracture with special reference to aetiology and improved surgical treatment, its occurrence in epileptics, note on Knuckle pads. Acta Chir Scand 1948;96(Suppl 39):25–175.
26.
go back to reference Smith AC. Diagnosis and indications for surgical treatment in Dupuytren’s contracture. Hand Clin 1991;7(4):635–41.PubMed Smith AC. Diagnosis and indications for surgical treatment in Dupuytren’s contracture. Hand Clin 1991;7(4):635–41.PubMed
27.
go back to reference Smith SP, Devaraj VS, Bunker TD.The association between frozen shoulder and Dupuytren’s disease. J Shoulder Elbow Surg 2001;10(2):149–51.PubMedCrossRef Smith SP, Devaraj VS, Bunker TD.The association between frozen shoulder and Dupuytren’s disease. J Shoulder Elbow Surg 2001;10(2):149–51.PubMedCrossRef
28.
go back to reference Thurston AJ. Dupuytren's disease. J Bone Jt Surg (Br) 2003;85-B(4):469–77.CrossRef Thurston AJ. Dupuytren's disease. J Bone Jt Surg (Br) 2003;85-B(4):469–77.CrossRef
29.
go back to reference Tropet Y, Deck D, Vichard P. Lesions of the little finger in Dupuytren’s disease. Ann Chir Main Memb Super 1994;13(2):101–6.PubMedCrossRef Tropet Y, Deck D, Vichard P. Lesions of the little finger in Dupuytren’s disease. Ann Chir Main Memb Super 1994;13(2):101–6.PubMedCrossRef
30.
go back to reference Tubiana R. Dupuytren’s disease of the radial side of the hand. Hand Clin 1999;15(1):149–59 (Feb).PubMed Tubiana R. Dupuytren’s disease of the radial side of the hand. Hand Clin 1999;15(1):149–59 (Feb).PubMed
31.
go back to reference Umraw N, Chan Y, Gomez M, Cartotto RC, Fish JS. Effective hand function assessment after burn injuries. J Burn Care Rehabil 2004;25(1):134–9.PubMedCrossRef Umraw N, Chan Y, Gomez M, Cartotto RC, Fish JS. Effective hand function assessment after burn injuries. J Burn Care Rehabil 2004;25(1):134–9.PubMedCrossRef
32.
go back to reference Woodruff MJ, Waldram MA. A clinical grading system for Dupuytren’s contracture. J Hand Surg (Br) 1998;23(3):303–305. Woodruff MJ, Waldram MA. A clinical grading system for Dupuytren’s contracture. J Hand Surg (Br) 1998;23(3):303–305.
Metadata
Title
Revised Tubiana’s Staging System for Assessment of Disease Severity in Dupuytren’s Disease—Preliminary Clinical Findings
Authors
Sandip Hindocha
John K. Stanley
James Stewart Watson
Ardeshir Bayat
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
HAND / Issue 2/2008
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-007-9071-1

Other articles of this Issue 2/2008

HAND 2/2008 Go to the issue