Severity of Contracture and Self-Reported Disability in Patients with Dupuytren’s Contracture Referred for Surgery

Recovery, responsiveness and interpretability of patient-reported outcome measures after surgery for Dupuytren’s disease

“…The DASH has been the most popular PROM for studying Dupuytren’s disease treatment (Ball et al, 2013). However, its validity has been questioned in a study with contemporary design (Forget et al, 2014), as well as in previous studies, which have more limitations (Degreef et al, 2009, Engstrand et al, 2009, Jerosch-Herold et al, 2011, Packham, 2011, Zyluk and Jagielski, 2007). Our study raises further questions regarding its suitability for use in Dupuytren’s disease, in terms of poor interpretability, an aspect of its behaviour that has not been studied previously for Dupuytren’s disease.…”

“…Recently, Dupuytren’s disease-specific measures have been developed (Beaudreuil et al, 2011, Mohan et al, 2014); the suitability of the DASH score has been questioned (Packham, 2011). Studies investigating the relationship between the DASH score and angular deformity show poor correlation between them (Degreef et al, 2009, Engstrand et al, 2009, Jerosch-Herold et al, 2011, Zyluk and Jagielski, 2007), but this is only detrimental to the DASH score if angular deformity is the ‘gold standard’ of patient-centred outcome in Dupuytren’s disease. Such an assumption is inappropriate when assessing validity in general (Mokkink et al, 2010); angular deformity is unlikely to be the best standard on which to base patient-centred outcome in Dupuytren’s disease (Rodrigues et al, 2014).…”

Functional outcome and complications following surgery for Dupuytren’s disease: a multi-centre cross-sectional study

“…While treating recurrent disease may be challenging, doing so following an aponeurotomy may be more straightforward than after more invasive surgery (van Rijssen and Werker, 2012), and so not all recurrences may have the same implications regarding future treatment. Furthermore, recurrence alone cannot be used as a surrogate for functional outcome, as the correlation between angular deformity and loss of function is weak (Engstrand et al, 2009; Jerosch-Herold et al, 2011; Zyluk and Jagielski, 2007).…”

“…In addition, failure to fully straighten a finger with treatment may not adversely affect outcome. These issues may explain why extension correlates poorly with functional outcome measures such as the Disabilities of the Arm, Shoulder and Hand (DASH) patient-reported outcome measure (PROM) (Degreef et al, 2009; Engstrand et al, 2009; Jerosch-Herold et al, 2011; Zyluk and Jagielski, 2007). However, a new Dupuytren’s disease-specific PROM, the Unité Rhumatologique des Affections de la Main (URAM) scale, correlates with angular deformity (Beaudreuil et al, 2011).…”

Factors affecting functional recovery after surgery and hand therapy in patients with Dupuytren's disease

“…(5) The extension deficit is a direct measure of the impairment whereas DASH is used to measure functional recovery, including impairments, activity limitations and participation restrictions. (6,7) The relationship between these commonly used outcome measures for patients with DD is still unclear; significant but weak correlations has been shown (8) as well as non-significant correlations between extension deficit and DASH score. (9)(10)(11)(12) This indicates that the degree of functional recovery is not dependent only on the severity of the contracture.…”