Types and stages of vascular remodeling in Dupuytren's contracture (analysis of 506 arteries in the surgical material of 111 patients)

Purpose Analysis of the severity and staging of pathomorphological changes in the arteries of palmar aponeurosis in patients with Dupuytren's contracture of different age groups Materials and methods Analysis of case records of patients younger than 50 years old (n = 19, group 1), from 50 to 65 years old (n = 60, group 2) and over 65 years old (n = 32, group 3). Light microscopy of paraffin sections of palmar aponeurosis fragments resected in partial fasciectomy and histomorphometry of palmar aponeurosis arteries of three calibers: small (outer diameter less than 150 microns), medium (150–300 microns), large (more than 300 microns). Control samples – fragments of the aponeurosis of three patients younger than 50 years old with hand injuries. Results Groups 1–3 are comparable in terms of fibromatosis duration, frequency of lesions in both hands, and the number of fingers with impaired function, but in group 3 the frequency of contractures in advanced stages and cardiovascular diseases was higher (p < 0.05). In arteries of small caliber, obliterating lesions and signs of expansive remodeling were also encountered; in arteries of medium caliber, expansive remodeling prevailed; in arteries of large caliber, constrictive remodeling was expressed. Discussion The types of remodeling identified were found in all age groups. Based on the results of the study and the data obtained earlier, 6 stages of pathomorphological changes in the vessels of the palmar aponeurosis were identified in Dupuytren's contracture. Conclusion Dupuytren's contracture refers to diseases mediated by vascular remodeling, affecting mainly the arterial bed, the severity and staging of which does not depend on the age of a patient.