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 (≈5%/day, P = .0005, R² = 0.08).

Discussion and conclusions: The observed rate of decrease in the measured force indicates a tissue adaptation time of approximately 3 hours.

Keywords: Dupuytren; Force; Postoperative hand splinting; Tissue adaptation.