Background: First described in 1833 by Baron Guillaume Dupuytren, Dupuytren’s Disease (DD) is a fibroproliferative disorder of the palmar fascia. There are currently multiple modalities available to the surgeon to treat DD. The aim of this study was to assess the current trends in DD management by Australian hand surgeons, and compare them to those utilised by American hand surgeons.
Methods: A questionnaire was sent to Australian hand surgeons containing 39 questions assessing the surgeon population factors such as age, speciality and fellowship training, treatment options and preferences, and outcomes, utilising similar questions as those presented in the American questionnaire. A total of 65 hand surgeons (25%) responded to the questionnaire.
Results: While the American survey found most respondents were orthopaedic surgeons in private practice who did not work with registrars, Australian hand surgeons were predominantly shared between plastic and orthopaedic surgeons, with most working with registrars. A similar percentage of Australian surgeons when compared to American surgeons use needle aponeurotomy (44% vs 39%) and limited fasciectomy (95% vs 100%), while Australian surgeons trend to using more collagenase (66% vs 77%). However, the complication profile and rates varied markedly between Australian and American hand surgeons for needle aponeurotomy, collagenase and limited fasciectomy.
Preference for treatment of isolated metacarophalgeal joint disease, and those with proximal interphalangeal joint disease as well, for primary and recurrent disease also varied between hand surgeons in Australia and America.
Conclusion: While multiple treatment modalities exist for the treatment of DD, this survey demonstrates at times large variability between surgeon treatment preference within the Australian hand surgeon population, which often also does not correlate with American hand surgeon preferences, suggesting surgeon treatment preference based on training and prior experience impacts significantly on treatment utilised.