DUPUYTREN LITERATURE: POSTOPERATIVE STIFFNESS

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Medline Title Search (Dupuytren + (stiff or stiffness))

Joint range of motion is influenced by age, gender and race. Stiffness is a common problem associated with Dupuytren disease, particularly after fasciectomy. Although most Dupuytren patients have normal flexion despite Dupuytren contracture, some have loss of full flexion before treatment. Risk factors for loss of finger flexion after treatment of Dupuytren contracture include preoperative stiffness, diabetes and disproportionate postoperative swelling (“flare reaction”).

Selected Publications

Descriptions

• Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis. 1973;32(5):413–8. (PDF)
• Kuczynski K. The proximal interphalangeal joint. Anatomy and causes of stiffness in the fingers. J Bone Joint Surg Br. 1968/08/01 ed. 1968 Aug;50(3):656–63. (PDF)
• Williams FM, Kalson NS, Fabiane SM, Mann D a., Deehan DJ. Joint Stiffness Is Heritable and Associated with Fibrotic Conditions and Joint Replacement. PLoS One. 2015;10(7):e0133629. (PDF)

Postoperative Dystrophy / Flare Reaction

• Zachariae L (1964). “Incidence And Course Of Posttraumatic Dystrophy Following Operation For Dupuytren’s Contracture.” Acta Chirurgica Scandinavica. Supplementum 15 (January): SUPPL 336:1-51. (PDF)

Medications

• Baxter H, Johnson L, Mader V, Schiller C. Cortisone as an adjunct in the treatment of postoperative stiffness of the hand. Can Med Assoc J. 1950/12/01 ed. 1950 Dec;63(6):540–2; French transl, 542–3. (PDF)

Dupuytren and Diabetes related stiffness

• Eadington DW, Patrick AW, Collier A, Frier BM. Limited joint mobility, Dupuytren’s contracture and retinopathy in type 1 diabetes: association with cigarette smoking. Diabet Med. 1989/03/01 ed. 1989;6(2):152–7. (PDF)
• Fournier K, Papanas N, Compson JP, Maltezos E. A diabetic patient presenting with stiff hand following fasciectomy for Dupuytren’s contracture: A case report. Cases J. 2008/10/29 ed. 2008;1(1):277. (PDF)
• Larkin JG, Frier BM. Limited joint mobility and Dupuytren’s contracture in diabetic, hypertensive, and normal populations. Br Med J (Clin Res Ed). 1986/06/07 ed. 1986 Jun 7;292(6534):1494. (PDF)
• Pal B, Griffiths ID, Anderson J, Dick WC. Association of limited joint mobility with Dupuytren’s contracture in diabetes mellitus. J Rheumatol. 1987/06/01 ed. 1987;14(3):582–5. (PDF)
• Slama G, Letanoux M, Thibult N, Goldgewicht C, Eschwege E, Tchobroutsky G. Quantification of early subclinical limited joint mobility in diabetes mellitus. Diabetes Care. 1985/07/01 ed. 1985;8(4):329–32. (PDF)

Treatment to regain flexion

• Comer GC, Clark SJ, Yao J. Hand Therapy Modalities for Proximal Interphalangeal Joint Stiffness. J Hand Surg Am. American Society for Surgery of the Hand; 2015;40(11):2293–6. (PDF)
• McClure PW, Blackburn LG, Dusold C. The use of splints in the treatment of joint stiffness: biologic rationale and an algorithm for making clinical decisions. Phys Ther. 1994;74(12):1101–7. (PDF)
• Midgley R. Use of casting motion to mobilize stiffness to regain digital flexion following Dupuytren’s fasciectomy. Hand Ther. 2010;15(2):45–51. (PDF)
• Rose RLL. The Use of CMMS (Casting Motion to Mobilise Stiffness) to Regain Digital Flexion Following Dupuytren’s Fasciectomy. lOth JFSSH Congr 7th JFSHT Congr. 2007;347–53. (PDF)
• Wisnicki JL, Leathers MW, Sangalang I, Kilgore ES. Percutaneous desmotomy of digits for stiffness from fixed edema. Plast Reconstr Surg. 1987;80(1):88–91. (PDF)