Dupuytren’s Contracture is an abnormal thickening and shortening of tissue in the palm. It most commonly affects the ring and little fingers and is found most often in men over the age of 50 whom are of Northern European descent.
Rehabilitation for Dupuytren’s contracture varies according to method of release. Following non-operative procedures patients are typically treated for 4 visits to develop a home program for symptom control, range of motion, and custom retainer splinting. Following surgical correction, patients are typically treated for 6-12 visits. Post surgical rehab often requires the need for wound care, modalities for management of more significant edema and pain, as well as soft tissue work to improve mobility.
Since 2010, radiation therapy has been trialed for contracture prevention and maintenance. It is theorized that radiation slows fibroblast development and growth rate, thus delaying the need for surgical management.
The goal, following all methods is the return of mobility, strength, and maximum functional use.
Plan of Care by Procedure
Radiation Therapy: Retainer splinting and exercise if motion is reduced.
Collagenase Injection: Retainer splinting, edema control, & exercise as needed.
Needle Aponeurotomy: Edema control, retainer splinting and exercise.
Open Fasciotomy: wound/graft care, edema/pain control, scar management, retainer splinting and exercise.
Custom hand or ﬁnger based digital retainer splint to maintain extension gained from procedure.
Prefabricated LMB splint for PIP ﬂexion contracture