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On the course, risk factors, and treatment outcomes of Dupuytren’s disease

PhD ceremony:Ms B.A. (Bente) van den Berge
When:August 30, 2023
Supervisor:prof. dr. P.M.N. (Paul) Werker
Co-supervisor:dr. D.C. (Dieuwke) Broekstra
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
On the course, risk factors, and treatment outcomes of
Dupuytren’s disease

On the course, risk factors, and treatment outcomes of Dupuytren’s disease 

This thesis investigated the disease progression and risk factors of Dupuytren's disease. The results show that a minority of the patients studied show disease progression after a seven-year period. Familial burden and having related diseases increase the risk of progression. Hand injury is a risk factor for the development of the disease.   

Increased risk Dupuytren hand workers   

We investigated the relationship between handwork exposure and Dupuytren's disease in a large-scale cohort study, which showed an increased risk of Dupuytren's disease in handworkers.  

Outcomes three most common treatments  

We also examined the outcomes of the three most common treatments for Dupuytren's disease: percutaneous needle fasciotomy, collagenase clostridium histolyticum injection and limited fasciectomy. These treatments showed similar corrections of contractures (forced muscle position).   

Injections with collagenase clostridium histolyticum resulted in more mild complications than the other treatments. Limited fasciectomy had the lowest recurrence risk up to five years after treatment. The long-term risk of re-treatment was found to be higher after percutaneous needle fasciotomy than after limited fasciectomy. Nevertheless, percutaneous needle fasciotomy seemed suitable for repeated application, as there was consistent effectiveness of corrections after multiple consecutive treatments.    

Remote patient monitoring  

Finally, we investigated the predictive value of hand function questionnaires on future treatment for Dupuytren's disease. Hand function scores measured about a year before treatment were found to be predictive of treatment. This shows we could use questionnaires in the future to monitor patients remotely.   

These findings could help optimise treatment of the disease and improve (individualised) patient care.