A Review of Common Practice in Dupuytren Surgery

Au-Yong, Iain; Wildin, C.; Dias, Joseph; Page, Robert E.

doi:10.1097/01.bth.0000186794.90431.a4

Cited by 58 publications

(43 citation statements)

References 17 publications

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“…All patients were treated according to a standard protocol (Figure 1 Fifteen patients needed more splinting than in the standard treatment: These included dynamic extension splints, dynamic flexion splints, exercise splints and wrist splints. The mean number of days before starting active exercise was 7 (range [5][6][7][8][9][10][11][12][13][14], the mean number of visits to the occupational therapist was 6 (range 2-13), and the mean number of visits to the physician was 3 (range 1-7).…”

Section: Interventionmentioning

confidence: 99%

Evaluation of Activity Limitation and Digital Extension in Dupuytren's Contracture Three Months after Fasciectomy and Hand Therapy Interventions

Engstrand¹,

Borén²,

Liedberg³

2009

Journal of Hand Therapy

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Section: Interventionmentioning

confidence: 99%

Evaluation of Activity Limitation and Digital Extension in Dupuytren's Contracture Three Months after Fasciectomy and Hand Therapy Interventions

Engstrand¹,

Borén²,

Liedberg³

2009

Journal of Hand Therapy

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“…Little evidence has been published on post-surgery regimens in Dupuytren's disease and their outcomes [16,17]. In western common medical practice, patients usually receive postoperative hand therapy.…”

Section: Discussionmentioning

confidence: 99%

Postoperative hand therapy in Dupuytren's disease

Herweijer

Dijkstra

Nicolai

et al. 2007

Disability and Rehabilitation

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Postoperative hand therapy in Dupuytren's disease Herweijer, H.; Dijkstra, P.U.; Nicolai, J.P.A.; van der Sluis, C.K. Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Herweijer, H., Dijkstra, P. U., Nicolai, J. P. A., & van der Sluis, C. K. (2007). Postoperative hand therapy in Dupuytren's disease. Disability and Rehabilitation, 29(22) This article maybe used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden.The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material. Abstract Background. Postoperative hand therapy in patients after surgery for Dupuytren's contracture is common medical practice to improve outcomes. Until now, patients are referred for postoperative hand rehabilitation on an empirical basis. Purpose. To evaluate whether referral criteria after surgery because of Dupuytren's disease were actually adhered to, and, to analyse differences in outcomes between patients who were referred according to the criteria (correctly referred) and those who were not referred but should have been (incorrectly not referred). Methods. Referral pattern was evaluated prospectively in 46 patients. Total active/passive range of joint motion (TAM/ TPM), sensibility, pinch force, Disability Arm Shoulder Hand questionnaire (DASH) and Michigan Hand outcomes Questionnaire (MHQ) were used as outcome measures preoperatively and 10 months postoperatively. Results. In total 21 patients were referred correctly and 17 patients were incorrectly not referred. Significant improvements on TAM/TPM, DASH and MHQ were found at follow-up for the total group. No differences in outcomes were found between patients correctly referred and patients incorrectly not referred for postoperative hand therapy. Conclusion. Referral criteria were not adhered to. Given the lack of differences in outcomes between patients correctly referred and patients incorrectly not referred, postoperative hand therapy in Dupuytren's disease should be reconsidered.

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“…Possible adverse effects of surgery are vascular or nerve damage, delayed wound healing, scar problems, infection, swelling, complex regional pain syndrome, and loss of finger flexion (4)(5)(6). Some surgeons recommend postoperative hand therapy (7)(8)(9), and according to clinical experience, recovery after surgery takes in general 3 to 6 months (8).…”

Section: Introductionmentioning

confidence: 99%

Hand Function and Quality of Life Before and After Fasciectomy for Dupuytren Contracture

Engstrand¹,

Krevers²,

Nylander³

et al. 2014

The Journal of Hand Surgery

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PurposeTo describe changes in joint motion, sensibility, and scar pliability and to investigate the patients' expectations, self-reported recovery, and satisfaction with hand function, disability, and quality of life after surgery and hand therapy for Dupuytren disease. MethodsThis prospective cohort study collected measurements before surgery and 3, 6, and 12 months after surgery and hand therapy. Ninety patients with total active extension deficits of 60 degrees or more from Dupuytren contracture were included. Outcomes measures were range of motion, sensibility, scar pliability, self-reported outcomes on expectations, recovery, and satisfaction with hand function, Disabilities of the Arm, Shoulder, and Hand scores, safety and social issues of hand function, physical activity habits, and quality of life with the Euroqol. ResultsThe extension deficit decreased, and there was a transient decrease in active finger flexion during the first year after surgery. Sensibility remained unaffected. Generally, patients with surgery on multiple fingers had worse scar pliability. The majority of the patients had their expectations met, and at 6 months 32% considered hand function as fully recovered, and 73%were satisfied with their hand function. Fear of hurting the hand and worry about not trusting the hand function were of greatest concern among safety and social issues. The Disability of the Arm, Shoulder and Hand score and the Euroqol improved over time. 2 ConclusionAfter surgery and hand therapy, disability decreased independent of single or multiple operated fingers. The total active finger extension improved enough for the patients to reach a functional range of motion despite an impairment of active finger flexion still present 12 months after treatment.

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A Review of Common Practice in Dupuytren Surgery

Cited by 58 publications

References 17 publications

Evaluation of Activity Limitation and Digital Extension in Dupuytren's Contracture Three Months after Fasciectomy and Hand Therapy Interventions

Evaluation of Activity Limitation and Digital Extension in Dupuytren's Contracture Three Months after Fasciectomy and Hand Therapy Interventions

Postoperative hand therapy in Dupuytren's disease

Hand Function and Quality of Life Before and After Fasciectomy for Dupuytren Contracture

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