Our Summary

This research was conducted to understand how diabetes affects the outcomes and patient satisfaction after surgery for Dupuytren contracture, a hand condition that causes fingers to bend into the palm. The researchers collected data from patients before and a year after their surgeries, over a period of six years (2013-2019). The patients were asked to fill out a QuickDASH score, which measures physical function and symptoms in people with musculoskeletal disorders of the upper limb, and to rate how normal their hand felt on a scale of 1 to 100.

The results showed that patients with diabetes generally reported worse physical function and symptoms both before and after the surgery compared to non-diabetic patients, but the difference was not clinically significant. In other words, even though the difference was statistically significant, it was not large enough to be considered significant in a real-world, clinical context.

Both diabetic and non-diabetic patients reported a significant improvement in how normal their hand felt after the surgery. However, non-diabetic patients reported a slightly higher level of hand normality after the surgery. Overall, patient satisfaction was high in both groups.

In conclusion, while diabetic patients with Dupuytren contracture may experience slightly worse outcomes after surgery, both diabetic and non-diabetic patients reported significant improvements and high levels of satisfaction after their surgeries.

FAQs

  1. Does diabetes mellitus impact the functional outcome and patient satisfaction after surgical treatment of Dupuytren contracture?
  2. Was there a significant difference in the pre and postoperative QuickDASH scores between diabetic and non-diabetic patients?
  3. How did patient satisfaction and self-perceived hand normality compare between diabetic and non-diabetic patients after surgery for Dupuytren contracture?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hand surgery is to follow postoperative instructions carefully, including keeping the hand elevated, performing prescribed exercises, and attending follow-up appointments. This can help ensure optimal healing and functional outcomes.

Suitable For

Patients with Dupuytren contracture who have diabetes mellitus may be recommended for hand surgery, as this study suggests that diabetic patients may have worse functional outcomes compared to non-diabetic patients. However, it is important to note that both diabetic and non-diabetic patients in this study reported high levels of satisfaction and significant improvements in self-perceived hand normality following surgery. Ultimately, the decision to recommend hand surgery for patients with Dupuytren contracture will depend on individual factors and the severity of their condition.

Timeline

Before hand surgery:

  • Patient experiences symptoms of Dupuytren contracture, such as hand deformity and limited hand function.
  • Patient consults with a hand surgeon to discuss treatment options.
  • Preoperative assessments and tests are conducted to evaluate the patient’s overall health and suitability for surgery.
  • Surgery is scheduled and the patient receives preoperative instructions and guidelines.

After hand surgery:

  • Patient undergoes the surgical procedure to correct Dupuytren contracture.
  • Patient is monitored in the recovery room and then discharged home with postoperative care instructions.
  • Patient attends follow-up appointments with the hand surgeon for wound checks and rehabilitation.
  • Patient completes PROMs, such as the QuickDASH score, to assess functional outcomes and satisfaction.
  • Patient experiences improvement in hand function and self-perceived hand normality following surgery, with high levels of patient satisfaction reported.

What to Ask Your Doctor

  1. How will my diabetes affect my recovery and outcome following hand surgery for Dupuytren contracture?
  2. What specific precautions or considerations should I take as a diabetic patient undergoing hand surgery?
  3. Will my diabetes impact the success of the surgery or the long-term outcome?
  4. Are there any additional risks or complications associated with hand surgery for diabetic patients?
  5. How will my diabetes management need to be adjusted before, during, and after the surgery?
  6. What can I do to optimize my recovery and healing as a diabetic patient undergoing hand surgery?
  7. Will my diabetes affect the timeline for returning to normal activities and work after the surgery?
  8. Are there any specific post-operative care instructions or medications that are important for diabetic patients to follow?
  9. Will I need any additional follow-up or monitoring as a diabetic patient after the surgery?
  10. Are there any lifestyle changes or precautions I should take as a diabetic patient to ensure the best possible outcome after hand surgery?

Reference

Authors: Stirling PHC, Duckworth AD, McEACHAN JE. Journal: J Hand Surg Asian Pac Vol. 2022 Jun;27(3):453-458. doi: 10.1142/S2424835522500473. PMID: 35808876