PubMed · 979843
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J T Hueston. 1976-07-31. Table top test.. https://doi.org/10.5694/j.1326-5377.1976.tb134472.x
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We reviewed ten hands in nine patients who had enzymatic fasciotomy for Dupuytren's contracture, with an average follow-up of 6.5 years. While all patients were initially satisfied with the results, the disease recurred quite rapidly to pre-operative levels in seven patients over the subsequent two to three years.
The purpose of this study was to prospectively compare the postoperative use of passive motion (PM) and standard hand therapy after surgical treatment of Dupuytren's disease for extent and rate of recovery of joint motion. Our data indicate that metacarpophalangeal joint contractures improved completely to a mean of 0 degrees, regardless of the postoperative protocol. Contractures at the proximal interphalangeal joint showed incomplete recovery in both study groups, with a mean residual contracture of 28 degrees for PM patients and 38 degrees for control patients. Contractures of the metacarpophalangeal-proximal interphalangeal joints in the same finger showed complete metacarpophalangeal joint recovery to a mean of 0 degrees but incomplete proximal interphalangeal joint recovery with a mean residual contracture of 30 degrees in PM patients and 22 degrees in control patients. We conclude that the use of a PM machine in the rehabilitation of Dupuytren's disease does not offer an advantage in the postoperative management of this condition.
The phenomenon of clinical regression of Dupuytren's contracture is described and discussed. It is already recognized and used in fasciotomy where it follows the release of longitudinal tension. The quite extraordinary resolution produced by continuous passive skeletal traction in extension is presented. Regression beneath grafted skin is described and discussed with its clinical implications. The generally accepted view of Dupuytren's contracture being "irreversible" now presents a challenge for further clinical and pharmacological studies. The possibility of non-surgical control does exist.