[An assessment of the influence of the severity of Dupuytren's contracture on the dexterity of the hand before and after surgery].

It seems to evident that deformation of the hand as a result of Dupuytren's contracture should cause weakness and overall functional impairment of the hand, and an increase of range of motion of the fingers as a result of the operation should effect in improvement of these parameters. The objective of this study was to investigate the effect of extension loss of fingers, number of fingers involved and age of the patients on the power and dexterity of the hand, as well as influence of the age of the patients and recovery of extension of the fingers on the power and dexterity of the hand after surgery for Dupuytren's contracture. 54 patients in an age range 32-83 years (mean 60) with the disease lasting av. 5 years underwent subtotal fasciectomy. Total extension loss of the fingers and total grip strength were measured and dexterity of the hand was assessed with DASH questionnaire prior to surgery. Patients were followed-up for 1 year and assessments were repeated at 1, 3 and finally at 12 months. Median values of measured variables at presentation were as follows: extension loss 80 degrees, total grip strength 41 kG, and DASH score 54. At 12 months median extension loss decreased to 10 degrees (stat. sign.), DASH score to 32 (stat. sign. improvement of dexterity) and grip strength decreased slightly to 40 kG. An analysis of the relationship between the variables showed that severity of the contracture (expressed as an extension loss) had no effect on dexterity of the hand but had significant influence on deterioration of the total grip strength. Number of fingers involved did affect neither dexterity nor power of the hand. Age of the patients did not influence subjective feeling of dexterity of the hand, however, older patients experienced lesser functional benefit from the operation, than younger patients. An increase of extension of the fingers following surgery had significant beneficial effect on subjective improvement of the dexterity of the hand, but had not effect on the increase of power of the hand.