The authors believe this information to be important to the patient, therapist, and surgeon in the assessment of postoperative recovery from this procedure.
This retrospective study examined the effect of night extension splinting on finger joint range of motion, pain, grip strength and hand function in post-fasciectomy Dupuytren's patients. In a group of 31 subjects, divided into those that had worn a night extension splint for the first three months of their rehabilitation and those that had never worn a night extension splint, assessment outcomes were collected retrospectively from the records at the subject's first assessment and at three months postoperatively. Statistical analysis between the two groups demonstrated that night extension splinting at three months post-fasciectomy for these subjects did not aid the maintenance of finger joint extension and reduced the rate of hand function resumption. However, night splintage did not cause a reduction in finger joint flexion. Night extension splinting for these subjects did not affect the recovery of hand grip strength nor did it affect the resolution of pain.
Routine use of night extension splintage did not achieve the aim of maintaining finger joint range of extension in these subjects. However, it would be inappropriate to apply these findings to the general population of Dupuytren's patients or alter any treatment regimes on the basis of these results due to the limitations of the study and the small sample size. It is suggested that more individual treatment programmes are appropriate rather than the routine regimes. A further prospective randomised controlled study with a larger sample size would be necessary to re-evaluate these findings.
A case report is presented detailing the development, medical and therapeutic treatment of a patient with severe complex regional pain syndrome of the upper limb. The sudden spontaneous recovery of this patient’s symptoms is discussed and the evidence for diagnosis of complex regional pain syndrome is reflected upon with reference to the adapted Budapest diagnostic criteria.
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