Sensor-Controlled Patient Compliance with Postoperative Splinting after Dupuytren's Surgery

Abstract

Surgery. 2 3 Dupuytren's disease is a fibroproliferative disease of palmar fascias of the hand that 4 can cause finger flexion contractures. This sometimes requires surgical intervention. 5 Postoperative night-time finger extension splinting is common practice, but its value 6 is not proven [1,2]. Patient compliance with splinting regimens is variable. Splints 7 equipped with a sensor allow to assess wearing time in a prospective and patient-8 blinded manner [3]. This study is the first to use this methodology to objectively 9 measure patient compliance with postoperative splinting after surgery for 10 Dupuytren's disease. 11 We prospectively included 25 patients (22 males and 3 females, mean age 63 years, 12 range 48-76) who underwent limited fasciectomy surgery for Dupuytren's disease. 13 Inclusion criteria were unilateral treatment of one or more fingers and a finger flexion 14 contracture of at least 30°. As part of the postoperative rehabilitation, all patients 15 were fitted with a custom-made thermoplastic palmar-sided, hand-based finger 16 extension splint. They were instructed to wear the splint every night for 90 days or 3 17 months. A sensor (Orthotimer, Balingen, Germany) was embedded in the splint (Fig. 18 1) and programmed to register temperature with 30-minute intervals. Temperature 19 threshold was set at 29,5°C so that body temperature could be used to assess actual 20 brace wear time. Patients were blinded to the purpose of the sensor to avoid 21 behaviour modification. At the final follow-up consultation at 3 months after surgery, 22