title: The effect of night extension orthoses following surgical release of Dupuytren contracture: a single-center, randomized, controlled trial.
abstract: OBJECTIVE
  To clarify the efficacy and detrimental effects of orthoses used to maintain finger extension following surgical release of Dupuytren contracture.
  
  
  METHODS
  We conducted a single-center, randomized, controlled trial to investigate the effect of night extension orthoses on finger range of motion and hand function for 3 months following surgical release of Dupuytren contracture. We also wanted to determine how well finger extension was maintained in the total sample. We randomized 56 patients to receive a night extension orthosis plus hand therapy (n = 26) or hand therapy alone (n = 30). The primary outcome was total active extension of the operated fingers (°). Secondary outcomes were total active flexion of the operated fingers (°), active distal palmar crease (cm), grip strength (kg), and self-reported hand function using the Disabilities of the Arm, Shoulder, and Hand questionnaire (0-100 scale).
  
  
  RESULTS
  There were no statistically significant differences between the no-orthosis and orthosis groups for total active extension or for any of the secondary outcomes. Between the first postoperative measure and 3 months after surgery, 62% of little fingers had maintained or improved total active extension.
  
  
  CONCLUSIONS
  The use of a night extension orthosis in combination with standard hand therapy has no greater effect on maintaining finger extension than hand therapy alone in the 3 months following surgical release of Dupuytren contracture. Our results indicate that the practice of providing every patient with a night extension orthosis following surgical release of Dupuytren contracture may not be justified except for cases in which extension loss occurs after surgery. Our results also challenge clinicians to research ways of maintaining finger extension in a greater number of patients.
authors.affiliation: Department of Hand Therapy, Manukau Super Clinic, Counties Manukau District Health Board, Auckland, New Zealand. juliecollis@gmail.com
authors.forename: Julie
authors.initials: J
authors.lastname: Collis
authors.forename: Shirley
authors.initials: S
authors.lastname: Collocott
authors.forename: Wayne
authors.initials: W
authors.lastname: Hing
authors.forename: Edel
authors.initials: E
authors.lastname: Kelly
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D004387:Dupuytren Contracture / Q000534:rehabilitation / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D009989:Orthotic Devices / Q000009:adverse effects; D016059:Range of Motion, Articular; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome