The effect of night extension orthoses following surgical release of Dupuytren contracture: A single-center, randomized, controlled trial

Julie Collis, Shirley Collocott, Wayne Hing, Edel Kelly

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Abstract

PURPOSE: To clarify the efficacy and detrimental effects of orthoses used to maintain finger extension following surgical release of Dupuytren contracture.

METHODS: We conducted a single-center, randomized, controlled trial to investigate the effect of night extension orthoses on finger range of motion and hand function for 3 months following surgical release of Dupuytren contracture. We also wanted to determine how well finger extension was maintained in the total sample. We randomized 56 patients to receive a night extension orthosis plus hand therapy (n = 26) or hand therapy alone (n = 30). The primary outcome was total active extension of the operated fingers (°). Secondary outcomes were total active flexion of the operated fingers (°), active distal palmar crease (cm), grip strength (kg), and self-reported hand function using the Disabilities of the Arm, Shoulder, and Hand questionnaire (0-100 scale).

RESULTS: There were no statistically significant differences between the no-orthosis and orthosis groups for total active extension or for any of the secondary outcomes. Between the first postoperative measure and 3 months after surgery, 62% of little fingers had maintained or improved total active extension.

CONCLUSIONS: The use of a night extension orthosis in combination with standard hand therapy has no greater effect on maintaining finger extension than hand therapy alone in the 3 months following surgical release of Dupuytren contracture. Our results indicate that the practice of providing every patient with a night extension orthosis following surgical release of Dupuytren contracture may not be justified except for cases in which extension loss occurs after surgery. Our results also challenge clinicians to research ways of maintaining finger extension in a greater number of patients.

Original languageEnglish
Pages (from-to)1285-94.e2
JournalJournal of Hand Surgery
Volume38
Issue number7
DOIs
Publication statusPublished - Jul 2013
Externally publishedYes

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Dupuytren Contracture
Orthotic Devices
Fingers
Randomized Controlled Trials
Hand
Hand Strength
Therapeutics
Articular Range of Motion
Arm

Cite this

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title = "The effect of night extension orthoses following surgical release of Dupuytren contracture: A single-center, randomized, controlled trial",
abstract = "PURPOSE: To clarify the efficacy and detrimental effects of orthoses used to maintain finger extension following surgical release of Dupuytren contracture.METHODS: We conducted a single-center, randomized, controlled trial to investigate the effect of night extension orthoses on finger range of motion and hand function for 3 months following surgical release of Dupuytren contracture. We also wanted to determine how well finger extension was maintained in the total sample. We randomized 56 patients to receive a night extension orthosis plus hand therapy (n = 26) or hand therapy alone (n = 30). The primary outcome was total active extension of the operated fingers (°). Secondary outcomes were total active flexion of the operated fingers (°), active distal palmar crease (cm), grip strength (kg), and self-reported hand function using the Disabilities of the Arm, Shoulder, and Hand questionnaire (0-100 scale).RESULTS: There were no statistically significant differences between the no-orthosis and orthosis groups for total active extension or for any of the secondary outcomes. Between the first postoperative measure and 3 months after surgery, 62{\%} of little fingers had maintained or improved total active extension.CONCLUSIONS: The use of a night extension orthosis in combination with standard hand therapy has no greater effect on maintaining finger extension than hand therapy alone in the 3 months following surgical release of Dupuytren contracture. Our results indicate that the practice of providing every patient with a night extension orthosis following surgical release of Dupuytren contracture may not be justified except for cases in which extension loss occurs after surgery. Our results also challenge clinicians to research ways of maintaining finger extension in a greater number of patients.",
author = "Julie Collis and Shirley Collocott and Wayne Hing and Edel Kelly",
note = "Copyright {\circledC} 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.",
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The effect of night extension orthoses following surgical release of Dupuytren contracture : A single-center, randomized, controlled trial. / Collis, Julie; Collocott, Shirley; Hing, Wayne; Kelly, Edel.

In: Journal of Hand Surgery, Vol. 38, No. 7, 07.2013, p. 1285-94.e2.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The effect of night extension orthoses following surgical release of Dupuytren contracture

T2 - A single-center, randomized, controlled trial

AU - Collis, Julie

AU - Collocott, Shirley

AU - Hing, Wayne

AU - Kelly, Edel

N1 - Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

PY - 2013/7

Y1 - 2013/7

N2 - PURPOSE: To clarify the efficacy and detrimental effects of orthoses used to maintain finger extension following surgical release of Dupuytren contracture.METHODS: We conducted a single-center, randomized, controlled trial to investigate the effect of night extension orthoses on finger range of motion and hand function for 3 months following surgical release of Dupuytren contracture. We also wanted to determine how well finger extension was maintained in the total sample. We randomized 56 patients to receive a night extension orthosis plus hand therapy (n = 26) or hand therapy alone (n = 30). The primary outcome was total active extension of the operated fingers (°). Secondary outcomes were total active flexion of the operated fingers (°), active distal palmar crease (cm), grip strength (kg), and self-reported hand function using the Disabilities of the Arm, Shoulder, and Hand questionnaire (0-100 scale).RESULTS: There were no statistically significant differences between the no-orthosis and orthosis groups for total active extension or for any of the secondary outcomes. Between the first postoperative measure and 3 months after surgery, 62% of little fingers had maintained or improved total active extension.CONCLUSIONS: The use of a night extension orthosis in combination with standard hand therapy has no greater effect on maintaining finger extension than hand therapy alone in the 3 months following surgical release of Dupuytren contracture. Our results indicate that the practice of providing every patient with a night extension orthosis following surgical release of Dupuytren contracture may not be justified except for cases in which extension loss occurs after surgery. Our results also challenge clinicians to research ways of maintaining finger extension in a greater number of patients.

AB - PURPOSE: To clarify the efficacy and detrimental effects of orthoses used to maintain finger extension following surgical release of Dupuytren contracture.METHODS: We conducted a single-center, randomized, controlled trial to investigate the effect of night extension orthoses on finger range of motion and hand function for 3 months following surgical release of Dupuytren contracture. We also wanted to determine how well finger extension was maintained in the total sample. We randomized 56 patients to receive a night extension orthosis plus hand therapy (n = 26) or hand therapy alone (n = 30). The primary outcome was total active extension of the operated fingers (°). Secondary outcomes were total active flexion of the operated fingers (°), active distal palmar crease (cm), grip strength (kg), and self-reported hand function using the Disabilities of the Arm, Shoulder, and Hand questionnaire (0-100 scale).RESULTS: There were no statistically significant differences between the no-orthosis and orthosis groups for total active extension or for any of the secondary outcomes. Between the first postoperative measure and 3 months after surgery, 62% of little fingers had maintained or improved total active extension.CONCLUSIONS: The use of a night extension orthosis in combination with standard hand therapy has no greater effect on maintaining finger extension than hand therapy alone in the 3 months following surgical release of Dupuytren contracture. Our results indicate that the practice of providing every patient with a night extension orthosis following surgical release of Dupuytren contracture may not be justified except for cases in which extension loss occurs after surgery. Our results also challenge clinicians to research ways of maintaining finger extension in a greater number of patients.

U2 - 10.1016/j.jhsa.2013.04.012

DO - 10.1016/j.jhsa.2013.04.012

M3 - Article

VL - 38

SP - 1285-94.e2

JO - Journal of Hand Surgery

JF - Journal of Hand Surgery

SN - 0363-5023

IS - 7

ER -