Correlation of Function with Deformity in Dupuytren Disease: The Condition-Specific Southampton Scoring Scheme Outperforms the Generic QuickDASH

Fig. 26.1

QuickDASH

In an effort to find a scale which is more valid in DD, we developed the Southampton Dupuytren’s Scoring Scheme (SDSS). This was derived by reducing many functional problems associated with DD into just five domains (Fig. 26.2), each relevant to DD (Mohan et al. 2014). In this study, we found that the SDSS had good internal consistency (Cronbach’s alpha 0.87) and high test-retest reliability (r = 0.79). In comparison with QD, it had favourable field characteristics and greater sensitivity to change (Standardised Response Mean SDSS −1.8; QD −1.2). Neither correlated well with goniometric deformity.

Fig. 26.2

Southampton Dupuytren’s Scoring Scheme

26.2 Aim

The aim of this study is to correlate function with deformity in a different and larger cohort of patients with DD and in particular to determine which of the SDSS and QD fare better.

26.3 Materials and Methods

We studied the functional problems associated with 298 cords in 237 patients with Dupuytren contracture who had chosen, following a full explanation of the choices, collagenase Clostridium histolyticum (Warwick et al. 2015).

We measured the angle of deformity (i.e. extension loss) with a standard goniometer just prior to injection. 99 patients had an MCP contracture, 56 a PIP contracture, 47 a natatory cord (i.e. one palmar cord contracting two digits) and 96 cords with combined MCP and PIP contracture. In those with natatory and combined contractures, we summated the extension loss in each cord. Immediately prior we also asked the patient to complete the SDSS and the QuickDASH.

26.4 Results

We found that whereas there was no correlation between the QuickDASH and angular deformity (Fig. 26.3, r = 0.01; p = 0.86), there was a modest correlation between SDSS and angular deformity (Fig. 26.4, r = 0.2; p = 0.002).