Improvement in Grip Strength Following Percutaneous Needle Aponeurotomy for Dupuytren's Disease: A Prospective Clinical Study.

BACKGROUND

Dupuytren's disease causes progressive flexion contractures and impaired hand function. While percutaneous needle aponeurotomy (PNA) provides rapid correction with low morbidity, the effect on grip strength remains unclear. Grip strength is a key surrogate of hand function and overall health, yet it has been inconsistently evaluated as an outcome in Dupuytren's disease.

METHODS

A prospective study was conducted at a tertiary referral center including 53 patients (80 digits) treated with PNA between February 2024 and March 2025. Standardized assessments included grip strength (Jamar dynamometer, American Society of Hand Therapists protocol), joint extension deficits, patient-reported outcomes (Southampton, Unité Rhumatologique des Affections de la Main [URAM]), and return-to-work data. Grip strength was reassessed at 2 months postprocedure to capture early functional recovery. Statistical analysis used paired t tests and Wilcoxon signed-rank tests, with significance set at P < .05.

RESULTS

Mean grip strength improved from 24.9 to 28.7 kg (mean change + 3.8 kg, P < .001). Extension deficits decreased significantly at all levels, with mean correction of 25.5° at the metacarpophalangeal joint (MCPJ) and 29.3° at the proximal interphalangeal joint (PIPJ) (P < .001). At 2 months, the median URAM score was 4 out of 45, and the Southampton score was 3 out of 20, reflecting excellent functional recovery. Forty-four employed patients returned to work within 1 week. Complications were minor (skin tears n = 9, transient hypersensitivity n = 1) with no major adverse events.

CONCLUSIONS

Percutaneous needle aponeurotomy (PNA) not only corrects digital contracture but also yields clinically significant improvements in grip strength, reinforcing its value as a functional outcome measure. These findings support PNA as a safe, effective first-line treatment for selected patients with Dupuytren's disease.