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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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The role of new rehabilitation protocol in Dupuytren’s disease

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  • presenting/speaker Francesco De Francesco - Dpt. of Reconstructive Plastic Surgery - Hand Surgery Unit, Ancona, Italy
  • Letizia Senesi - Clinical Orthopeadics, Dpt. of Reconstructive Plastic Surgery - Hand Surgery Unit, Ancona, Italy
  • Oletta Serpilli - Clinical Neurorehabilitation, Ancona, Italy
  • Elisa Romani - Clinical Neurorehabilitation, Ancona, Italy
  • Pierfrancesco Pugliese - Dpt. of Reconstructive Plastic Surgery - Hand Surgery Unit, Ancona, Italy
  • Michele Riccio - Dpt. of Reconstructive Plastic Surgery - Hand Surgery Unit, Ancona, Italy

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1244

doi: 10.3205/19ifssh0065, urn:nbn:de:0183-19ifssh00657

Published: February 6, 2020

© 2020 De Francesco et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Dupuytren's disease (DD) is a benign fibroproliferative disorder characterized by the progressive development of a scar-like, collagen-rich cord within the palmar fascia of the hand which typically results in a permanent finger contracture. Recurrences are high in DD and its causes are almost unknown actually. In our opinion the adherence of an appropriate post-operative rehabilitation protocol is fundamental. In literature, there are not studies that assess the correct post-operative management in DD. The aim of the present study is evaluating the outcomes of a new post-operative rehabilitation protocol.

Methods: From February 2016 to February 2018, 78 patients were treated in our department. Collected clinical data included patient demographic data, post-operative side effects, type of treatment, protocol accession, rate of recurring events at follow-up time. The Anova one-way test was performed to evaluate the statistical significance of recurrences (p<0.05) in both groups: patients who adhere to rehabilitation protocol and who not adhere.

Results and Conclusions: We excluded 7 patients treated for recurrences. A total of 71 patients were submitted to the first surgery and in 44 cases (62%) the disease involved a single digital ray. In 34 cases (48%), we performed enzymatic cordotomy (Xiapex), in 37 cases (52%) was performed open surgery (aponeurectomy, cordectomy, dermoaponeurectomy). Post-operative side effects included wound dehiscence (5 cases in enzymathic cordotomy, 3 cases in open group). Statistical analysis does not reveal any correlation between adherence to protocol and rate of recurring events in both groups, according to literature.

In conclusion, DD represents a mysterious pathology and currently the causes of recurrences are unknown. Rehabilitation protocol may be useful to regain an early complete function of the hand, but it does not influence the rate of recurrences. However further and multicenter studies will be necessary to understand the role of rehabilitation in this disease.