Postoperative hand therapy in Dupuytren's disease

Background. Postoperative hand therapy in patients after surgery for Dupuytren's contracture is common medical practice to improve outcomes. Until now, patients are referred for postoperative hand rehabilitation on an empirical basis. Purpose. To evaluate whether referral criteria after surgery...

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Bibliographic Details
Published in:Disability and rehabilitation 2007-01, Vol.29 (22), p.1736-1741
Main Authors: Herweijer, Hester, Dijkstra, Pieter U., Nicolai, Jean-Philippe A., van der Sluis, Corry K.
Format: Article
Language:English
Subjects:
Aged
Dupuytren Contracture - rehabilitation
Dupuytren Contracture - surgery
Dupuytren's disease
Female
Guideline Adherence
hand therapy
Hands
Humans
Male
Middle Aged
Occupational Therapy
outcomes
Physiotherapy
Postoperative care
Range of Motion, Articular
Recovery of Function
Referral and Consultation - standards
Referrals
Rehabilitation
Severity of Illness Index
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Summary:Background. Postoperative hand therapy in patients after surgery for Dupuytren's contracture is common medical practice to improve outcomes. Until now, patients are referred for postoperative hand rehabilitation on an empirical basis. Purpose. To evaluate whether referral criteria after surgery because of Dupuytren's disease were actually adhered to, and, to analyse differences in outcomes between patients who were referred according to the criteria (correctly referred) and those who were not referred but should have been (incorrectly not referred). Methods. Referral pattern was evaluated prospectively in 46 patients. Total active passive range of joint motion (TAM TPM), sensibility, pinch force, Disability Arm Shoulder Hand questionnaire (DASH) and Michigan Hand outcomes Questionnaire (MHQ) were used as outcome measures preoperatively and 10 months postoperatively. Results. In total 21 patients were referred correctly and 17 patients were incorrectly not referred. Significant improvements on TAM TPM, DASH and MHQ were found at follow-up for the total group. No differences in outcomes were found between patients correctly referred and patients incorrectly not referred for postoperative hand therapy. Conclusion. Referral criteria were not adhered to. Given the lack of differences in outcomes between patients correctly referred and patients incorrectly not referred, postoperative hand therapy in Dupuytren's disease should be reconsidered.
ISSN:0963-8288
1464-5165
DOI:10.1080/09638280601125106