Background / Aims: Full finger extension is not always achieved post fasciectomy and may result in functional impairment. Generic patient rated outcome measures (PROM) have traditionally been used to measure function. In 2011 a Dupuytren disease specific PROM was introduced entitled the Unité Rhumatologique des Affections de la Main (URAM)(Beaudreuil et al., 2011). This study was undertaken to investigate the relationship between extension deficit and functional impairment following fasciectomy; to identify if any degree of extension loss will predict functional impairment and to examine the clinical usefulness of the URAM.
Methods: Data were collected on 42 patients at 3 months post fasciectomy at the Manukau Super Clinic Hand Therapy Clinic. Extension deficit was measured in degrees as total active extension (TAE) (MCP+PIP+DIP extension). A spearman correlation was performed to establish the relationship between extension deficit and function as measured by the URAM.
Results: A moderate positive correlation of 0.5 (95% CI, 0.24 0.70) was found. This was not influenced by hand dominance, which finger or the number of fingers operated on. All participants with a combined extension deficit of greater than 30 degrees reported some functional impairment.
Conclusions: Findings suggest that in general, greater extension loss is associated with functional impairment. A TAE of more than 30 degrees can predict at least one functional difficulty. The URAM is a clinically useful tool in measuring functional deficit post fasciectomy. It may be limited in its ability to capture a broad spectrum of functional difficulties.
Counties Manukau Health