Our Summary

This research paper is about a study that looked at the effects of a specific treatment for Dupuytren disease, a condition that causes the fingers to bend towards the palm, making it hard to use the hand. The treatment is called percutaneous needle fasciotomy (PNF) and it’s used to cut and break up the bands that are causing the fingers to bend.

The study followed 75 patients who had this procedure over a four month period. The patients were asked to rate the appearance and function of their hand both before and after the surgery, and again two weeks later.

The results showed that straight after the operation, patients rated the appearance of their hand as significantly better than before the surgery. Two weeks later, the appearance score had gone up a bit (meaning they thought their hand looked a bit worse), but it was still much better than before the operation. The function score, which measures how well they could use their hand, also improved significantly two weeks after the procedure.

The researchers conclude that this treatment improves both the look and function of the hand in patients with Dupuytren disease. However, they note that more research is needed to see if these improvements last in the long term.

FAQs

  1. What is the purpose of the Percutaneous needle fasciotomy (PNF) in treating Dupuytren disease?
  2. What were the aesthetic and functional outcomes 2 weeks after PNF for patients with Dupuytren contracture?
  3. How were the Visual Analogue Appearance Score (VAAS), Derriford Appearance Score (DAS), and the quick Disabilities of the Arm, Shoulder and Hand score (QuickDASH) used in the study of PNF’s effectiveness in treating Dupuytren disease?

Doctor’s Tip

One helpful tip a doctor might give a patient about hand surgery, specifically for Dupuytren disease, is to expect improvements in both aesthetic and functional outcomes at 2 weeks post-surgery. It is important to follow up with longer-term evaluations to determine if these improvements are sustained. Additionally, it is important to complete any recommended post-operative exercises or physical therapy to optimize recovery and functionality in the hand.

Suitable For

Patients with Dupuytren disease who have contracture bands in the hand are typically recommended for hand surgery, specifically percutaneous needle fasciotomy (PNF). This procedure can help improve both aesthetic and functional outcomes in these patients. In the study mentioned, patients who underwent PNF for Dupuytren disease showed significant improvement in aesthetic outcomes immediately postoperatively and at 2 weeks after surgery. Additionally, functional outcomes, as measured by the QuickDASH score, also improved 2 weeks after surgery. It is important to note that longer-term follow-up is needed to determine the sustainability of these improvements.

Timeline

  • Preoperative: Patients complete Visual Analogue Appearance Score (VAAS), Derriford Appearance Score (DAS), and Quick Disabilities of the Arm, Shoulder and Hand score (QuickDASH) assessments
  • Immediate postoperative: Patients complete VAAS assessment
  • 2 weeks postoperative: Patients complete VAAS, DAS, and QuickDASH assessments
  • Preoperative VAAS decreases significantly immediately post operation
  • 2 weeks postoperative VAAS increases slightly but remains significantly lower than preoperatively
  • DAS remains unchanged
  • QuickDASH score decreases significantly from preoperative to 2 weeks postoperative
  • Overall, percutaneous needle fasciotomy for Dupuytren contracture results in improvement in both aesthetic and functional outcomes at 2 weeks. Longer term follow-up is needed to determine if these improvements are sustained.

What to Ask Your Doctor

  1. What is the success rate of PNF for Dupuytren contracture in terms of both aesthetic and functional outcomes?
  2. What are the potential risks or complications associated with PNF surgery for Dupuytren disease?
  3. How long is the recovery period following PNF surgery for Dupuytren contracture?
  4. Will I need to participate in physical therapy or rehabilitation after PNF surgery?
  5. Can you explain the postoperative care instructions I will need to follow after PNF surgery for Dupuytren disease?
  6. What is the likelihood of recurrence of Dupuytren contracture following PNF surgery?
  7. Are there any alternative treatment options for Dupuytren disease that I should consider?
  8. How soon after PNF surgery can I expect to see improvement in both aesthetic and functional outcomes?
  9. Will I need to take any medications or undergo additional procedures after PNF surgery for Dupuytren contracture?
  10. Can you provide me with information on the long-term outcomes of PNF surgery for Dupuytren disease?

Reference

Authors: Johnson N, Kurien T, Selby A, O’Brien M. Journal: J Hand Surg Asian Pac Vol. 2022 Feb;27(1):62-67. doi: 10.1142/S2424835522500059. Epub 2022 Jan 14. PMID: 35037575