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Hand Function after Surgery for Dupuytren's

Dupuytren's disease causes a tightening of the fingers, called contractures. Dupuytren's most often pulls the small and ring finger into flexion (towards the palm of the hand). Sometimes the middle finger gets a contracture, too. The authors of this report have done other studies showing improved hand function after surgery for Dupuytren's. In this study they look at which joints are most responsible for improved hand function after surgery.

Thirty patients were tested before and after surgery. Angle of joint deformity was measured for two joints, the MCP and PIP joints. The MCP joints form the knuckles across the back of the hand. The PIP joints are the middle joints of each finger. All patients had contractures of one or more joints in one or more fingers.

All but one patient had improved MCP and PIP joints when checked six months and 12 months after surgery. Results showed that the more deformity present in the joints, the worse the hand function. Improving PIP motion has a greater effect on hand function than improving MCP motion.

The authors conclude that joint position does make a difference in hand function for patients with Dupuytren's disease. Both the MCP and the PIP joints are important. But it is especially important that deformed PIP joints be corrected.

References: Kingsley Paul Draviaraj, MRCS Ed, and Indranil Chakrabarti, FRCS Ed (Orth). Functional Outcome after Surgery for Dupuytren's Contracture: A Prospective Study. InThe Journal of Hand Surgery. September 2004. Vol. 29A. No. 5. Pp. 804-808.

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