Validation of a Handprint for Clinical Evaluation of Dupuytren's Contracture

Abstract

Objective We have developed a handprint-based method for visualizing and quantifying the palmar contact of patients with Dupuytren's contracture. The purpose of this study was to examine whether the generated handprint was useful for assessing the severity of flexion contracture of the fingers and for evaluating the therapeutic effects of collagenase clostridium histolyticum (CCH) injection for Dupuytren's contracture.

Methods The handprint was created by applying medical-grade ethanol-containing hand sanitizer over the entire palmar surface of the affected hand and then pressing it on thermal paper for word processors. The reliability of the handprint was evaluated through test–retest of 10 healthy volunteers at an interval of 10 days, and the validity of the handprint was assessed using a flexion contracture model in which the little finger was fixed in an Alfence splint. In addition, we obtained handprints of the affected hand in 33 patients with unilateral Dupuytren's contracture both before CCH injection and at the final observation after injection to investigate the contact area of the hand (CAH) and the length of the hand (LH). The relationships between CAH, LH, total extension deficit angle (TEDA), and patient-reported outcome measures (Japanese Society for Surgery of the Hand Version of the Quick Disability of Arm, Shoulder, and Hand Questionnaire [Quick DASH-JSSH] and Hand20) were examined.

Results The test–retest correlation coefficient was 0.9187 (p < 0.001) for CAH and 0.9052 (p < 0.001) for LH, indicating high reliability of the handprint. The ratios of CAH and LH decreased gradually as the contracture angle of the splinted finger increased. The handprint revealed a marked improvement of palmar contact after CCH injection for Dupuytren's contracture. Furthermore, the ratios of CAH and LH were strongly correlated with TEDA, Quick DASH-JSSH, and Hand20 before treatment.

Conclusion Our handprint-based assessment method was extremely useful for clinical evaluation of CCH treatment for Dupuytren's contracture.

Type of Study/Level of Evidence Therapeutic.

Keywords

Dupuytren's contracture - handprint - collagenase injection

Publication History

Article published online:
25 August 2021

• References

• 1 Hueston JT. The table top test. Hand 1982; 14 (01) 100-103
• 2 Imaeda T, Toh S, Wada T. et al. Impairment Evaluation Committee, Japanese Society for Surgery of the Hand. Validation of the Japanese Society for Surgery of the Hand Version of the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH-JSSH) questionnaire. J Orthop Sci 2006; 11 (03) 248-253
• 3 Suzuki M, Kurimoto S, Shinohara T, Tatebe M, Imaeda T, Hirata H. Development and validation of an illustrated questionnaire to evaluate disabilities of the upper limb. J Bone Joint Surg Br 2010; 92 (07) 963-969
• 4 Moritomo H, Imaeda T, Gotani H. et al. Functional Evaluation Committee of Japanese Society for Surgery of Hand. Reliability of the Hand20 questionnaire: comparison with the 36-Item Short-Form Health Survey. Hand Surg 2014; 19 (01) 1-6
• 5 Dupuytren B. Permanent retraction of the fingers, produced by an affection of the palmar fascia. Lancet 1834; 2: 222-225
• 6 Desai SS, Hentz VR. The treatment of Dupuytren disease. J Hand Surg Am 2011; 36 (05) 936-942
• 7 Gilpin D, Coleman S, Hall S, Houston A, Karrasch J, Jones N. Injectable collagenase Clostridium histolyticum: a new nonsurgical treatment for Dupuytren's disease. J Hand Surg Am 2010; 35 (12) 2027-38.e1
• 8 Badalamente MA, Hurst LC. Enzyme injection as nonsurgical treatment of Dupuytren's disease. J Hand Surg Am 2000; 25 (04) 629-636
• 9 Badalamente MA, Hurst LC, Hentz VR. Collagen as a clinical target: nonoperative treatment of Dupuytren's disease. J Hand Surg Am 2002; 27 (05) 788-798
• 10 Hurst LC, Badalamente MA, Hentz VR. et al. CORD I Study Group. Injectable collagenase clostridium histolyticum for Dupuytren's contracture. N Engl J Med 2009; 361 (10) 968-979
• 11 Meyerding HW. Dupuytren's contracture. Arch Surg 1936; 32: 320-333
• 12 Tubiana R. Dupuytren's disease of the radial side of the hand. Hand Clin 1999; 15 (01) 149-159
• 13 Budd HR, Larson D, Chojnowski A, Shepstone L. The QuickDASH score: a patient-reported outcome measure for Dupuytren's surgery. J Hand Ther 2011; 24 (01) 15-20, quiz 21
• 14 Ball C, Pratt AL, Nanchahal J. Optimal functional outcome measures for assessing treatment for Dupuytren's disease: a systematic review and recommendations for future practice. BMC Musculoskelet Disord 2013; 14: 131
• 15 Forget NJ, Jerosch-Herold C, Shepstone L, Higgins J. Psychometric evaluation of the Disabilities of the Arm, Shoulder and Hand (DASH) with Dupuytren's contracture: validity evidence using Rasch modeling. BMC Musculoskelet Disord 2014; 15: 361
• 16 Rodrigues J, Zhang W, Scammell B. et al. Validity of the Disabilities of the Arm, Shoulder and Hand patient-reported outcome measure (DASH) and the Quickdash when used in Dupuytren's disease. J Hand Surg Eur Vol 2016; 41 (06) 589-599
• 17 Bradley J, Warwick D. Patient satisfaction with collagenase. J Hand Surg Am 2016; 41 (06) 689-697
• 18 Beaudreuil J, Allard A, Zerkak D. et al. URAM Study Group. Unité Rhumatologique des Affections de la Main (URAM) scale: development and validation of a tool to assess Dupuytren's disease-specific disability. Arthritis Care Res (Hoboken 2011; 63 (10) 1448-1455
• 19 Bernabé B, Lasbleiz S, Gerber RA. et al. URAM scale for functional assessment in Dupuytren's disease: a comparative study of its properties. Joint Bone Spine 2014; 81 (05) 441-444
• 20 Mohan A, Vadher J, Ismail H, Warwick D. The Southampton Dupuytren's Scoring Scheme. J Plast Surg Hand Surg 2014; 48 (01) 28-33