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Occupational Therapy
Dupuytrens Treatment
Dupuytrens
*Often cited as being of genetic origin, primarily affecting individuals of
Northern European descent.
*Associated with diabetes, hypothyroidism, smoking, chronic
pulmonary disease and seizure disorders.
*Men affected more than women, onset usually 50 to 70 years
*Active cellular process in the fascia of the hand. Pathological changes
occur in the fascia with thickening and shortening of the fascia leading to
contracture and loss of function.
*Surgery when contracture becomes a functional problem
*Therapy goal is to promote wound healing, control scar formation, increase
range of motion, provide splinting, and maximize function in ADLs
*Digital nerves and arteries (neurovascular bundles) may become shortened with
flexion contractures. These can take several weeks to grow the needed length
after contracture release.
This must be remembered during serial splinting post surgery
Avoid attempting full extension of the fingers in the first 3 weeks
*Referral to Occupational Therapy for pre-op education
Dupuytrens splint
References
Burke; Higgins; et al. Hand and Upper Extremity Rehabilitation 3rd ed. Pg 539- 545.
Elsevier 2006
Hunter, Macklin and Callahan eds. Rehabilitation of the Hand: Surgery and Therapy
4th ed. Pg 981-994. Mosby
Dr. A. Hollister, MD. Associate Professor Orthopaedic Surgery LSUHSC
Carla Saulsbery LOTR, CHT LSUHSC