Dupuytren's disease: A reality in Black Africa

• Published in: Hand surgery and rehabilitation 2020-10, Vol.39 (5), p.448-453
• Main Authors: Coulibaly, N.F., Doumbia, M.M., Dembele, B., Dia, R., Fall, M.E.K., Sane, A.D., Dieme, C.B.
• Format: Article
• Language: English
• Subjects: Aponévrose; Contracture; Dupuytren; Fascia; Hand; Main; Rétraction; Senegalese; Sénégalais
• ISSN: 2468-1229; 2468-1210
• DOI: 10.1016/j.hansur.2020.04.005

Long regarded as a disease exclusively found amongst Northern Europeans, Dupuytren's disease was seldom studied amongst Black Africans. Thus, we sought to study the impact of Dupuytren's disease, its etiological, clinical and evolutionary peculiarities on a segment of the Senegalese population. This study analyzed data derived from clinical observations carried out between January 2006 and December 2018. It involved Senegalese subjects with Dupuytren's disease, the patients’ history, profession, habitus, clinical findings, therapeutic modalities and disease staging. The population included 20 men and 6 women averaging 63.5 years of age (range 45–77). None of the patients reported a family of Dupuytren's disease. Twelve patients had diabetes, 11 were smokers and 22 were engaged exclusively in manual labor. The condition was bilateral in 14 cases. Tubiana stages N, I, II, III and IV were found in 31, 15, 9, 5 and 6 rays, respectively. Conservative treatment was done in 11 patients. Surgical treatment was carried out in the other 15 patients: needle fasciotomy (N=10) including two bilateral involvement and open fasciectomy (N=7). Functional outcomes were satisfactory. Lesions were all stable in the short and medium term. Two patients had progressive lesions on a longer-term basis. Dupuytren's disease is real among Afro-descendants from Senegal even though it is seldom studied. Based on the patients’ recollection of Dupuytren's disease in their families, heredity is not yet a proven factor. The early forms are more common, and the lesions remain stable for a long time. Longtemps considérée comme une maladie de sujets d’ascendance nord-européenne, la maladie de Dupuytren a été rarement étudiée chez les Africains. Le but de ce travail était d’étudier l’impact de la maladie de Dupuytren, ses particularités étiologiques, cliniques et évolutives sur un segment de la population sénégalaise. Cette étude prospective a été menée de janvier 2006 à décembre 2018 chez les patients reçus pour la maladie de Dupuytren. Les paramètres étudiés étaient les antécédents, la profession, l’habitus, les aspects cliniques, les modalités thérapeutiques et évolutives. Il s’agissait de 20 hommes et 6 femmes âgés en moyenne de 63,5 ans (de 45 à 77 ans). De mémoire, aucun des patients n’a signalé un cas similaire de la maladie de Dupuytren dans sa famille. Douze patients étaient diabétiques, 11 fumeurs, 22 avaient une activité exclusivement manuelle. La localisation était bilatérale dans