Splinting as a Therapeutic Option in Dupuytren Contractures

Degreef, Ilse; Brauns, Annelien

doi:10.1007/978-3-319-32199-8_47

Cited by 1 publication

(2 citation statements)

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“…If present, scar treatment is standard, comprising application of pressure through a splint or paper tape, and sometimes includes silicone treatment [23]. If the scar is hard or hypertrophic, use of a splint together with a silicone sheet is recommended [26–28]. Scar and oedema treatment is recommended for 12 h per day for 2 months or more, if needed [41].…”

Section: Methodsmentioning

confidence: 99%

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Hand therapy or not following collagenase treatment for Dupuytren’s contracture? Protocol for a randomised controlled trial

Aglen

Matre

Lind

et al. 2019

BMC Musculoskelet Disord

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Background Dupuytren’s contracture (DC) is a fibrotic hand condition in which one or more fingers develop progressive flexion deformities. Quality of life is diminished due to disabling limitations in performing everyday activities. For DC patients treated with collagenase, referral for subsequent hand therapy is inconsistent. It is unknown whether subsequent hand therapy is beneficial compared to no therapy. The purpose of this study is to determine whether hand therapy improves DC patients’ performance of and satisfaction with performing everyday activities one year after collagenase treatment. Methods We will conduct a randomised controlled trial with two treatment groups (hand therapy vs. control) of DC patients who have received collagenase treatment. DC patients with contracted metacarpophalangeal joint(s) (MCPJ) (hand therapy, n = 40; control, n = 40) and those with proximal interphalangeal joint(s) (PIPJ) involvement (hand therapy, n = 40; control, n = 40) comprise two subgroups, and we will study if the treatment effect will be different between both groups ( n = 160). Patients with a previous injury or treatment for DC in the treatment finger are excluded. Hand therapy includes oedema and scar management, splinting, movement exercises, and practice of everyday activities. The main outcome variable is patients’ performance of and satisfaction with performing everyday activities, as assessed with the Canadian Occupational Performance Measure. Secondary outcomes are DC-specific activity problems, as assessed with the Unité Rhumatologique des Affections de la Main scale, and active/passive flexion/extension of treated joints and grip force using standard measuring tools, and self-reported pain level. Demographic and clinical variables, degree of scarring, cold hypersensitivity, number of occupational sick-leave days are collected. Self-reported global impression of change will be used to assess patient satisfaction with change in hand function. Assessments are done pre-injection and 6 weeks, 4 months, and 1 year later. Standard univariate and multivariate statistical analyses will be used to evaluate group differences. Discussion This study aims to assess whether hand therapy is beneficial for activity-related, biomechanical, and clinical outcomes in DC patients after collagenase treatment. The results will provide an objective basis for determining whether hand therapy should be conducted after collagenase treatment. Trial registration This study has been registered at ClinicalTrials.gov as NCT03580213 (April 5, 2018).

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Section: Methodsmentioning

confidence: 99%

“…Recommendations for hand therapy after treatment for DC vary in the literature and in practice. Patient education, oedema management [23–25], wound care and scar management [26–28], splinting, exercises, passive stretching, and graded return to everyday activities are mentioned [13].…”

Section: Introductionmentioning

confidence: 99%