A Study of the Effect of Night Extension SpLintage on Post Fasciectomy Dupuytren's Patients

Abstract

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.

Optimal functional outcome measures for assessing treatment for Dupuytren’s disease: a systematic review and recommendations for future practice

“…Mean final follow-up times for function PROMs ranged from 3 months [22,35] to 4.5 years [36]. Final follow up times for studies recording pre- and post-operative DASH scores varied between 5 weeks and 48 months.…”

“…Functional outcomes reported by intervention; Collagenase injection, needle fasciotomy and surgery [3,6,7,15,16,20,22]–[30,33,35]–[45,47,48,50]–[109]. …”

The lived experience of Dupuytren’s disease of the hand

“…Literature related to Dupuytren’s disease is mainly quantitative research assessing surgical interventions, describing postoperative care and clinical reports of the disease (Andrew et al. 1991, McFarlane 1997, Glassey 2001, Bulstrode et al. 2004).…”

“…Literature related to Dupuytren's disease is mainly quantitative research assessing surgical interventions, describing postoperative care and clinical reports of the disease (Andrew et al 1991, McFarlane 1997, Glassey 2001, Bulstrode et al 2004. The most common evidence-based treatment is surgery to correct the deformity, with postoperative rehabilitation to restore hand function (Wilson 1997, Bulstrode et al 2004.…”

Clinical effectiveness of post-operative splinting after surgical release of Dupuytren's contracture: a systematic review

“…There were no prospective, randomised, controlled trials and the 4 studies included one controlled trial without randomisation[ 19 ], one prospective observational study without control or comparator group[ 20 ], and one retrospective case review [ 21 ]. Evans et al's study [ 22 ] included retrospective case review as well as prospective comparison of two groups.…”