Functional outcome after surgery for Dupuytren's contracture: a prospective study

The purpose of this study was to assess the functional outcome after surgery for Dupuytren's contracture and the correlation between the change in the degree of deformity of the metacarpophalangeal joint (MCPJ) and the proximal interphalangeal joint (PIPJ) and the change in hand function.

Hand function in 30 patients was assessed by Sollerman hand function tests prospectively both before surgery and at 6 and 12 months after surgery. The deformity at the MCPJ and PIPJ was measured in degrees of angulation. The results were analyzed using the Spearman rank correlation test. In patients with multiple finger involvement the data were analyzed twice: first by using the measurements for the finger with the worst deformity and then repeating the analysis after the mean deformity was calculated.

The mean preoperative MCPJ and PIPJ deformity was 31 degrees (range, 30 degrees to 76 degrees ) and 35 degrees (range, 30 degrees to 96 degrees ), respectively. The mean correction at the MCPJ and PIPJ was 19.6 degrees and 16 degrees , respectively. The mean preoperative Sollerman score was 72.8, which improved to 77.9 at 12 months after surgery. There was a statistically significant correlation between the total correction, PIPJ correction, and hand function at 6 and 12 months, but not with MCPJ correction. In those patients with multiple finger involvement these correlations remained true regardless of whether the mean or greatest deformity was considered.

We conclude that improvement in deformity in Dupuytren's contracture leads to an improvement in hand function and that an improvement in the PIPJ contracture has a greater correlation with hand function than an improvement in the MCPJ contracture.