Post-Surgical Rehabilitation of Dupuytren's Disease: A Retrospective Study

• Autor(a) principal: Pereira Barbeiro, Carolina; Centro de Medicina de Reabilitação de Alcoitão, Alcoitão, Portugal
• Data de Publicação: 2017
• Outros Autores: Mendes Ribeiro, Inês; Hospital Fernando da Fonseca, Amadora, Portugal, Ladeira, André; Hospital Fernando da Fonseca, Amadora, Portugal, Dias, Ana; Hospital Fernando da Fonseca, Amadora, Portugal, Cadete, Ana; Hospital Fernando da Fonseca, Amadora, Portugal
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.25759/spmfr.252
• topic: Dupuytren Contracture/rehabilitation; Postoperative Care; Contratura de Dupuytren/reabilitação; Cuidados Pós-Operatórios

Introduction: Dupuytren’s disease is a benign proliferative connective tissue disorder that involves the hand’s palmar fascia. The first clinical signs reported by the patients are thickening near the MCP. The small finger is the most affected. Dupuytren’s disease is more common in men over 40 years old. Diabetes mellitus, alcohol use, smoking and HIV have all been associated with a higher risk of Dupuytren’s disease. Surgical intervention is the gold standard on Dupuytren’s treatment and is indicated in cases of advanced disease. Postoperative rehabilitation should start between 3 and 5 days with early range of motion and palmar shift.Purpose: Characterize the post-operative population with Dupuytren’s disease and evaluate gains with the intervention of rehabilitation.Method: Retrospective and descriptive longitudinal study using the clinical data of surgically treated patients with Dupuytren’s disease evaluated and treated according with a protocol of occupational therapy at our department. Results: From a total of 50 surgically treated patients, between January 2014 and August 2015, 92% were men. The average age was 64.22 years. Risk factors association was predominantly diabetes mellitus (22%), smoking (8%) and moderate to severe alcoholic habits (6%). A percentage of 54% were intervened in the right hand, and the majority of the patients were intervened in the 5th finger (38%). Forty two patients (84%) attended the sessions twice a week. Thirteen patients abandoned the treatment before the end. The treatment had an average length of 70.14 days (SD 42.5). In comparison between the beginning and the end of the rehabilitation program there were a significantly difference in the range of motion of the extension and flexion of the MCP (p = 0.00, p = 0.03) and PIP (p = 0.00, p = 0.01). Other statistical significant relations were not foundDiscussion and Conclusion: Surgery followed by a structured rehabilitation program in Dupuytren’s disease allows an improvement in range of motion.