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J Hand Microsurg 2022; 14(04): 308-314
DOI: 10.1055/s-0041-1725221
Original Article

Comparison of Hand Therapy with or without Splinting Postfasciectomy for Dupuytren's Contracture: Systematic Review and Meta-Analysis

Mohammad Karam‡   *
1   School of Medicine, University of Leeds, United Kingdom
,
Narvair Kahlar‡   *
1   School of Medicine, University of Leeds, United Kingdom
,
Ahmad Abul‡   *
1   School of Medicine, University of Leeds, United Kingdom
,
Shafiq Rahman
2   Department of Plastic Surgery, Hull University Teaching Hospitals NHS Trust UK, United Kingdom
,
Richard Pinder
2   Department of Plastic Surgery, Hull University Teaching Hospitals NHS Trust UK, United Kingdom
› Author Affiliations Funding None.
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Abstract

This study aimed to compare the outcomes of hand therapy alone versus additional splinting post fasciectomy for Dupuytren's contracture patients. A systematic review and meta-analysis were conducted, and a search was performed identifying all relevant studies comparing the two groups. Primary outcome measures included Total active flexion and extension (TAF and TAE) and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Secondary outcome measures included pain intensity, grip strength, and global perceived effect and patients' satisfaction. A random effects model was used for the analysis. Four RCTs were identified enrolling 295 patients. There were no significant differences between hand therapy and splintage groups in terms of all outcomes (both primary and secondary). Splintage offers no added functional benefit to hand therapy alone for post fasciectomy patients with Dupuytren's contracture, however, orthotic regimes may still be applied on an intention to treat basis in those patients who develop an extension deficit postoperatively.

Keywords

hand therapy - splinting - Dupuytren's contracture - fasciectomy - postfasciectomy

Author Contributions

M.K., N.K., and A.A. contributed equally as first joint authors in the acquisition, statistical analysis, and interpretation of data as well as drafting the manuscript. S.R. and R.P. were responsible for study concept, design, and supervision. All authors read and approved the final manuscript.


* M.K., N.K., and A.A. contributed equally as first joint authors.




Publication History

Article published online:
11 March 2021

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