Histological features of fascial fibromatosis in patients with rapid progression of Dupuytren’s contracture

Purpose. Comparative analysis of palmar fascia tissue components and histomorphometry of perforating arteries in patients with rapid and typical progression of Dupuytren’s contracture (DC). Materials and Methods. A total of 222 medical records of patients operated on in the period 2014-2019 were analyzed. The period of development of DC in the largest group (n=88) – from three to eight years – was defined as typical, the development of DC in two years or less (n=41) was interpreted as rapid. Histomorphometry of surgical material was performed in cases of rapid (n=20, group 1) and typical (n=25, group 2) progression of DC. Control samples – fragments of the palmar aponeurosis of conditionally healthy people excised during surgical treatment of hand wounds (n=5). Results. The content of hyperplastic connective tissue varied in both groups. In group 1, the content of microcirculatory vessels was increased, including pathologically altered and newly formed ones (CD34+). Histomorphometry of the perforating arteries of the palmar aponeurosis showed that in the medium-caliber arteries of patients in groups 1 and 2, compared with the control, the outer diameter was increased by 4% (p0.05) and 12.5% (p0.01), respectively, and the diameters of the lumens in group 1 were reduced by 30% (p0.01), and in group 2 they were increased by 31% (p0.05). In large-caliber arteries in groups 1 and 2, the outer diameter, compared to the control, decreased by 18% (p0.01) and 17% (p0.05), and the lumen diameters decreased by 52% (p=0.00) and 18% (p0.05), respectively. Conclusion. Despite the shorter duration of the disease, patients with rapid progression of DC showed an increase in the number of pathologically altered vessels in the microcirculatory bed and more pronounced stenotic remodeling of the perforating arteries of the palmar aponeurosis, which verifies early vascular aging. Histological predictors of postoperative recurrence of DC should be assessed individually, regardless of the duration of the disease.