A STUDY OF THE REPEATABILITY OF THE DIAGNOSIS OF DUPUYTREN CONTRACTURE AND ITS PREVALENCE IN THE GRAMPIAN REGION

200 consecutive geriatric patients over 60 years of age (100 men and 1 00 women) were examined for signs of Dupuytren's contracture and quest ioned about certain risk factors thought to be associated with the dis ease. Each patient was examined, independently, by two orthopaedic sur geons. The diagnosis of Dupuytren's contracture was established by the finding of a thickening in the palm fixed to the palmar fascia as a n odule or band. However each patient was also examined for skin tetheri ng, flexion contractures of digits and knuckle pads. The results were then analysed and a Kappa test performed on the data to assess the int er-observer variability in eliciting the signs of Dupuytren's contract ure. Using the Kappa test agreement between the two observers was foun d to be, on average, 1.0 for observing flexion contractures, 0.8 for o bserving skin tethering, 0.7 for observing palmar nodules and 0.7 for observing knuckle pads. The two observers both made the diagnosis of D upuytren's contracture in 21% of women and 39% of men. These figures a re high compared with previously published data from other centres and confirm the locally held belief that Dupuytren's contracture is parti cularly prevalent in North-east Scotland.