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 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.