Thursday, 27 November 2014

Gender bias and trauma in Ledderhose and Dupuytren's

The large patient survey we are conducting has already revealed many interesting facts. One of these facts is that it appears that although Dupuytren's is more common in men (as expected), Ledderhose however appears to have a higher prevalence in women.

In order to investigate this further I have done a shorter survey with a lot of help from 2 Facebook groups.

Hypothesis and Method: 

The apparent different gender bias of Ledderhose and Dupuytren's is caused by the different lifestyles of men and women. Men are more likely to have jobs that will cause repetitive strain on their hands whilst women are more likely to put strain on their feet by wearing high heels.

Therefore this survey was to see whether there were more markers for trauma in the hand in Dupuytren's patients and whether there was more signs of trauma in Ledderhose patients.

The survey can still be taken here.


Graph 1: Percentage of patient groups with or without hand issue
The results in graph one are separated out into Dupuytren's, Dual and Ledderhose patients and within in group it is separated into men and women and those with or without a hand issue (trauma or job requiring repetitive use, pre-diagnosis). The results for Dupuytren's and Dual patients (all Dupuytren's patients) are quite similar in that over 55% of patients report having had a hand issue. Interestingly however if we use the Ledderhose patients as a control group we see a much lower percentage of patients report having had any issues with their hands. This suggests that within a Dupuytren's and Ledderhose patient group those with trauma to their hands are more likely to have developed Dupuytren's. 

Graph 2: Percentage of patient groups with or without a foot issue. 
The results of graph 2 are the same principle as graph 1 but the Ledderhose patients are on the left and Dupuytren's on the right. Here there appears to be no correlation between foot usage and the likelihood of Ledderhose development. 

Graph 3: Break down of levels of each foot factor.
Graph 3 is then a breakdown of each of the factors considered for the foot, this is to see whether any of these by themselves show a higher level of association with Ledderhose. Although there appears to be an increased level of high heel usage in female Ledderhose patients compare to Dupuytren's patients the difference and number of responses to the survey are too low to say if this is significant. Looking at the numbers I feel this is unlikely to be significant but this cannot be confirmed without more participants. 

As a final note I wanted to show how few Ledderhose only patients there are. This survey was shared on multiple groups and pages consisting of both Ledderhose and Dupuytren's patients, however less than 15% of patients have Ledderhose alone, 35% have both and just over 50% have Dupuytren's. This data matches that expected based on the large survey being conducted and it will be interesting to see whether, for example, the current age of the Ledderhose patients is on average lower than those with both. 


Dupuytren's patients show a higher level of hand trauma and or use than non-Dupuytren's patients, Ledderhose patients do not show a higher level of high heel use, trauma, running or high use of feet jobs.