Tissue adaptation rate in the treatment of Dupuytren contracture

Abstract

Study Design: Basic research (cross-sectional). Introduction: Dupuytren disease can cause disabling contractures of the finger joints. After partial fasciectomy, postoperative hand splinting helps to maintain extension range of motion. Purpose of the Study: To measure how the contraction forces of the finger on the splint change over time. Methods: Subjects who were treated for Dupuytren contracture with partial fasciectomy were invited to participate in this study. Force sensors were placed in their dorsal extension splint, and the applied force was measured continually for several weeks. Results: Eleven subjects (aged 59-75 years) with the metacarpophalangeal (8) or proximal interphalangeal (3) as their most severely affected finger joint participated. Each night, the measured force consistently decreased to reach a plateau after about 3 hour (adaptation time, 2.55; 95% confidence interval, 0.2-31.8 hours). The time to reach this plateau decreased with time after surgery (z5%/day, P ¼ .0005, R 2 ¼ 0.08). Discussion and Conclusions: The observed rate of decrease in the measured force indicates a tissue adaptation time of approximately 3 hours.

Design and Test of a New Inductive Force Sensor

“…Preliminary results of measurements in the treatment of habitual toe walkers, Dupuytren fingers [ 21 ], and clubfeet [ 22 ] show excellent functioning for long-term measurement. Encountered problems in these applications were of a practical nature and were resolved with improved design: delamination of the aluminum target at the removal of the sensor was resolved by adding a post-it on top, battery failure was resolved by enhanced feedback with two LEDs on the AU and problems with identifying the start of important events in the logging was resolved by adding an input button on the AU.…”

Design and Evaluation of Magnetic Hall Effect Tactile Sensors for Use in Sensorized Splints

“…For this, a thickness constraint was applied to prevent the inclusion of sensors from modifying the functionality of the splint. We used the thickness constraint applied by Giesberts et al with a maximum sensor thickness of 3 mm [8]. This thickness, while larger than some other tactile sensors, allows for a higher range of deformation and assists in keeping the sensor in constant contact with the hand, reducing the effects of bad fitting observed in some splint designs [15].…”

“…There is currently little information reported in the literature on the typical pressures which might be observed at the splint-skin interface, and to the best of the authors knowledge, the shear stresses at this interface have not been reported. From current literature, the standard pressures experienced are around 1 kPa for upper limb splints, rising to around 20 kPa under abnormal loading [5,6,8]. This range may vary based on the placement of sensors, with differing forces experienced around anatomical landmarks, however future research will be need to confirm this.…”

“…Other groups have used pressure sensing within splints to measure disease progression and quantify the success of different treatment methods of musculoskeletal diseases. Giesberts et al used a tactile sensing unit, applied to the inner face of a cast and splint, to measure the correction of club-foot and Dupuytren disease [7,8]. Both devices monitored the pressure of the orthotic on the underlying skin over a period of up to 12 hours, indicating a 95% reduction in applied pressure over the study.…”

HAILO: A Sensorised Hand Splint for the Exploration of Interface Forces

“…To date, there has been little reported use of force sensing in hand splints. Of the few examples, a device used by Giesberts et al [19], [20] used a single axis inductive force sensor to measure the variance of interface force in a hand splint for Dupuytren Contracture. A single-axis force sensor (10 mm diameter) was placed adjacent to an affected metacarpophalangeal or proximal interphalangeal joint.…”