Postoperative hand therapy in Dupuytren's disease

Abstract

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.

Steroid Injection and Needle Aponeurotomy for Dupuytren Contracture: A Randomized, Controlled Study

“…[33][34][35] Patient-reported outcomes were not evaluated due to the lack of a validated instrument for specific use in Dupuytren disease patients. Reports of patient satisfaction must play a role in treatment options and should be assessed in all outcome studies.…”

Development of a Brief, 12-Item Version of the Michigan Hand Questionnaire

“…Therefore, we would expect that the brief-MHQ would also have similar content validity. (12, 14, 15, 39, 40) Criterion validity describes the extent to which a survey instrument compares with the accepted reference standard. Currently, there is no established standard by which to measure health outcomes related to hand dysfunction across a wide range of acute and chronic hand conditions.…”

Critical Angles of Deformity in Dupuytren’s Contracture of the Little and Ring Fingers

“…The ranges of angles were chosen to include those in the BSSH guidelines and in previous studies investigating hand function and DC deformity. [1][2][3][4][5][6][7] They were fastened with elastic Velcro strapping around the palm and proximal phalanx to the right hand of the participants to allow for flexion of the digit. Adhesive felt padding was applied to its inner surface to allow improved fit among participants.…”