title: The incidence of postoperative flare reaction and tissue complications in Dupuytren's disease using tension-free immobilization.
abstract: OBJECTIVE
  Open fasciectomy represents a standard treatment of Dupuytren's disease. Although patients are commonly immobilized in extension to prevent postoperative contracture formation, immobilizing the extremity under tension may precipitate a flare reaction and scar-related complications. This study explores the incidence of flare reaction and other complications with postoperative tension-free splinting after fasciectomy for Dupuytren's contracture.
  
  
  METHODS
  We retrospectively reviewed patients' charts that consisted of 228 procedures in 191 patients who underwent surgery by the senior author between 2000 and 2010. Postoperative notes were reviewed for wound healing problems, scar appearance, flare reaction, and complications. The grading system defined by Evans et al. was used to standardize flare reaction and scar complications.
  
  
  RESULTS
  Using tension-free splinting, the incidence of flare reaction was 3.5 % (8/228). The eight patients that had flare reactions had mild involvement, and no severe reaction was observed. Fifteen patients had hypertrophic scars, eight had hypersensitive scars, and six had recurrent contractures.
  
  
  CONCLUSIONS
  The incidence of flare reaction using tension-free immobilization postoperatively was low in our study. According to our findings, wound healing problems are rare when tensionless splinting is utilized. Type of study/level of evidence Case series, Level IV, Therapeutic study.
authors.affiliation: Rothman Institute, Thomas Jefferson University, Philadelphia, PA USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Rivlin
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, PA USA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Osterman
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, PA USA.
authors.forename: Sidney M
authors.initials: SM
authors.lastname: Jacoby
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, PA USA.
authors.forename: Terri
authors.initials: T
authors.lastname: Skirven
authors.affiliation: Thomas Jefferson University, Philadelphia, PA USA.
authors.forename: Uzoma
authors.initials: U
authors.lastname: Ukomadu
authors.affiliation: The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, PA USA.
authors.forename: A Lee
authors.initials: AL
authors.lastname: Osterman
keywords: Complications; Dupuytren; Flare; Flare reaction; Splinting