Prospective analysis of grip strength and load distribution after surgical treatment of common diseases of the hand with novel’s manugraphy® system

Abstract

Background Carpal tunnel syndrome, A1 annular pulley stenosis and Dupuytren’s contracture are among the most common conditions of the hand. In this study, we investigated the impact of surgical procedure on hand grip strength and high-resolution spatial load distribution in individuals suffering from those diseases over a follow-up period of one year. Materials and methods In this prospective study, data of 9 patients with carpal tunnel syndrome, 12 patients with A1 annular pulley stenosis and 7 patients with Dupuytren’s contracture were evaluated. Only patients with unilateral disease were included providing the contralateral hand as an intra-individual control. Grip strength was measured with cylindrical instruments in two different sizes with respect to the hand size of the patients. Maximum and average values of grip strength as well as spatial load distribution in each finger, thenar, hypothenar and palm were analyzed. Data of the affected patients were collected preoperatively and 6 weeks, 6 months and 1 year postoperatively. Grip strength and spatial load distribution were compared preoperatively to postoperatively. In addition, DASH score, Levine score, 2-point discrimination and degree of flexion contracture were assessed. Results The patients with A1 annular pulley stenosis showed a significant increase in grip strength 6 months and one year postoperatively. Patients with carpal tunnel syndrome and Dupuytren’s contracture showed no significant difference in grip strength over the course of time. An increase in the percentual grip strength of the thenar in patients with carpal tunnel disease and within the affected finger in A1 annular pulley stenosis was observed over the course of time. The DASH score was significantly lower in all patient cohorts one year postoperatively. Conclusion Surgical procedure in carpal tunnel syndrome, A1 annular ligament stenosis and Dupuytren’s contracture improves the functionality of the hand in everyday life. Some areas of the hand seem to compensate other weaker areas in grip strength.

Is there an impact of a video-based patient informed consent in elective hand surgery?

“…While various modern digital diagnostic tools in hand surgery have been studied extensively [ 8 – 11 ], there is a limited scientific evaluation of digital tools in the context of the informed consent process. Educating patients before surgery is a vital aspect of a physician's responsibility, contributing significantly to building trust between patients and the healthcare professionals.…”

Langzeitergebnisse nach Rekonstruktion von Fingerdefekten mittels Cross-Finger-Lappenplastik

“…Das Ergebnis des Quick-DASH-Scores inklusive des "Arbeits-und Berufsmodul" zeigt, dass die Patienten eine sehr gute bis gute Wiedereingliederung ins Alltag-und Berufsleben erfahren, sodass eine frühzeitige Mobilisierung mit dem erhöhten Risiko einer Durchblutungskomplikation der Cross-Finger-Lappenplastik unserer Ansicht nicht sinnvoll erscheint. Eine Analyse der Grobgriffkraft könnte weitere Daten zur Wiederherstellung der Funktion liefern, bedürfen aber der Messung der Ausgangssituation, was traumabedingt problematisch ist [20].…”