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

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 (r²=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.