title: Hand function and quality of life before and after fasciectomy for Dupuytren contracture.
abstract: OBJECTIVE
  To describe changes in joint motion, sensibility, and scar pliability and to investigate the patients' expectations, self-reported recovery, and satisfaction with hand function, disability, and quality of life after surgery and hand therapy for Dupuytren disease.
  
  
  METHODS
  This prospective cohort study collected measurements before surgery and 3, 6, and 12 months after surgery and hand therapy. Ninety patients with total active extension deficits of 60° or more from Dupuytren contracture were included. Outcomes measures were range of motion; sensibility; scar pliability; self-reported outcomes on expectations, recovery, and satisfaction with hand function; Disabilities of the Arm, Shoulder, and Hand scores; safety and social issues of hand function; physical activity habits; and quality of life with the Euroqol.
  
  
  RESULTS
  The extension deficit decreased, and there was a transient decrease in active finger flexion during the first year after surgery. Sensibility remained unaffected. Generally, patients with surgery on multiple fingers had worse scar pliability. The majority of the patients had their expectations met, and at 6 months, 32% considered hand function as fully recovered, and 73% were satisfied with their hand function. Fear of hurting the hand and worry about not trusting the hand function were of greatest concern among safety and social issues. The Disability of the Arm, Shoulder, and Hand score and the Euroqol improved over time.
  
  
  CONCLUSIONS
  After surgery and hand therapy, disability decreased independent of single or multiple operated fingers. The total active finger extension improved enough for the patients to reach a functional range of motion despite an impairment of active finger flexion still present 12 months after treatment.
  
  
  METHODS
  Therapeutic IV.
authors: Department of Hand Surgery, Plastic Surgery and Burns, County Council of Östergötland; Division of Physiotherapy, and Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University; Linköping, Sweden. Electronic address: christina.engstrand@lio.se.
authors: Christina
authors: C
authors: Engstrand
authors: Department of Hand Surgery, Plastic Surgery and Burns, County Council of Östergötland; Division of Physiotherapy, and Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University; Linköping, Sweden.
authors: Barbro
authors: B
authors: Krevers
authors: Department of Hand Surgery, Plastic Surgery and Burns, County Council of Östergötland; Division of Physiotherapy, and Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University; Linköping, Sweden.
authors: Göran
authors: G
authors: Nylander
authors: Department of Hand Surgery, Plastic Surgery and Burns, County Council of Östergötland; Division of Physiotherapy, and Division of Health Care Analysis, Department of Medical and Health Sciences, Linköping University; Linköping, Sweden.
authors: Joanna
authors: J
authors: Kvist
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D004387:Dupuytren Contracture / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery*; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D019637:Orthopedic Procedures / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
keywords: Dupuytren contracture; occupational therapy; range of motion; satisfaction; surgical treatment