Clinical Research Directory

Kinesitherapy Plus Osteopathy After Surgery for Dupuytren Disease

This randomized, double-blind clinical trial evaluates whether adding targeted osteopathy to physiotherapy improves recovery after open surgery for Dupuytren disease. Patients who have undergone their first open fasciectomy for Dupuytren disease will be randomly assigned to one of two groups. Both groups will receive physiotherapy. One group will additionally receive a targeted osteopathy session, while the other group will receive a sham osteopathy session. The main objective is to evaluate recovery of extension of the metacarpophalangeal joint of the operated finger. Secondary outcomes include hand function, extension of the proximal and distal interphalangeal joints, grip strength, scar vascularization, quality of life, scar adherence, and postoperative pain. The study will include 50 adult patients. Participants will be followed for 12 weeks, with assessments at 1, 4, 8, and 12 weeks after the start of treatment.

Skin Involvement in Dupuytren Surgical Treatment Outcome

Palmar skin is often retracted in Dupuytren disease (DD), making surgical management challenging and skin-preserving surgery difficult. Based on clinical experience in DD surgery and outcome, it is suspected that recurrence may be associated with such retracted skin. Possibly, this is due to presence and persistence of aligned myofibroblasts (MF), fixed to the deepest dermal layers. This interventional study aims to investigate the pathophysiological involvement of palmar skin in Dupuytren disease, and its implications for prognostics and treatment.

Ultrasound Features of Dupuytren's Disease

Dupuytren's disease (DD) is a benign and progressive condition that affects the palmar aponeurosis with a very high global incidence. It can result in significant loss of hand function or can inhibit an individual's daily activities or work. Current diagnostics rely on Range Of Motion (ROM) measurements and clinical expertise, where the decision for treatment is primarily based on patient preferences with little scientific research supporting different options in different cases. With technological advancements new options arise to the possible diagnostic tools that can be used for evidence based medicine and shared decision making. One option comes to light for DD because of its cheap, non -invasive and no radiation load, namely ultrasound (US). The use of US for DD is not standard care, due to the lack of research surrounding this tool. This study will provide some insight into the use of US for DD and will primarily try to evaluate different parameters measurable with US that can be used as potential prognostic biomarkers.