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Table 1 Clinical staging and grading systems for Dupuytren’s disease

From: Systematic review of non-surgical treatments for early Dupuytren’s disease

Author Iselin (1951) [13] Shaw (1951) [57] Steinberg (1951) [18] Luck (1959) [8] Early (1962) [12] Chiu and McFarlane (1978) [10] Tubiana (1968) [17] Tubiana: Keilholz modification (1996) [14] Tubiana: Seegenschmiedt modification (2001) [15]
Grade or Stage 0: Small nodules, hand function not affected 1: Hands with a nodule in the palmar fascia not yet involving the skin and causing no contracture of the fingers 1: Fibrosis of palmar fascia without contractures Proliferative stage: nodules in the palm and fingers 0: Palmar nodules Early disease: nodules in the palmar fascia without digital contracture N: Palmar nodule without presence of contracture As Tubiana As Tubiana
1: Nodules and cords in the palm and early contracture of MCPJ 2: Nodule in the fascia involving the skin but not causing finger flexion deformity 2: Contractures up to 135° toward the palm Involutional stage: development of finger flexion contractures 1 point: total digital deformity of60° Active disease: nodular thickening with associated digital contracture 1: Total flexion deformity (TFD) between 0° and 45° N/1: TFD 1–5 N/1: TFD 1–10
2: MCPJ contracture up to 30° and early PIPJ contracture 3: Nodule in the palm invading skin plus flexion contracture of one or more fingers 3: Contractures up to 90° toward the palm Residual stage: cord development and finger contractures with joint changes 2 points: 61 to 120° Advanced disease: Progressive joint contracture for more than 3 years with diffuse palmar fibrotic thickening 2: TFD between 45° and 90° 1: TFD 6–45 1: TFD 11–45
3: Contracture of IPJs more than 30° 4: Includes all stage 3 cases in which the secondary changes have occurred in the tendons or joints of one or more fingers. 4: Fibrosis of palmar fascia, with flexion deformities of the fingers beyond 90° toward the palm.   3 points: >120   3: TFD between 90° and 135° As Tubiana As Tubiana
4: Extreme digital flexion contracture. Sensory and circulatory disturbance       4: TFD greater than 135° As Tubiana As Tubiana
  1. Normal text indicates early stage disease as defined for this review. Italic text indicates later stage disease not included in this review