Preoperative Serial Casting, Education, and Therapy for Dupuytren's Contracture
We're running a small study at Dorset County Hospital for people having surgery for Dupuytren's contracture, a condition that causes fingers to bend. The study tests a special therapy before surgery, which includes gentle casting, stretching, and massage. This therapy aims to loosen tight tissues in the hand to help improve movement after surgery. We're looking at who might benefit, what results are most important to measure, and how practical the therapy is. The main goal is to see if this pre-surgery therapy could lead to better outcomes and if a larger study should be done in the future to confirm these findings.
At a glance
What is this study about?
Dupuytren's contracture is a common hand condition where the tissue in the palm tightens, causing one or more fingers to bend inwards. This can make it difficult to do everyday things. For many people, surgery is the most effective way to fix this, but sometimes the finger doesn't straighten as much as hoped, especially for severe bends.
This small study is looking into whether a short course of therapy before surgery might help improve recovery. This therapy involves gentle heat, stretching, massage, and something called 'serial casting'. Serial casting means applying soft casts that gently stretch the finger, with the cast being adjusted weekly to gradually lengthen the tight tissues. The idea is that if the tissues are made more flexible before surgery, the finger might move better afterwards.
We're doing this study at Dorset County Hospital and inviting people who are already scheduled for Dupuytren's surgery and have a significant bend in their finger. The main aim is to find out if this pre-surgery therapy is practical and acceptable, and if it shows enough promise to justify a much larger study in the future. We also want to learn the best ways to measure improvement, such as how much the finger can move or how strong the grip is.
Key takeaways
- It's a small study checking new pre-surgery therapy for Dupuytren's contracture.
- The therapy includes special casting, stretching, and massage to help finger movement.
- It's for people having surgery at Dorset County Hospital with a bent finger of 30+ degrees.
- The aim is to see if this therapy could lead to better recovery.
- This study will help decide if a larger trial is needed in the future.
Who may be eligible?
You might be able to take part in this study if you are 18 years or older and are currently waiting for surgery for Dupuytren's contracture at Dorset County Hospital. Specifically, you need to have a bend of 30 degrees or more in the middle knuckle of one or more fingers due to Dupuytren's. You must also be willing and able to understand and agree to take part in the study and attend all the follow-up appointments.
However, there are reasons why you wouldn't be able to join. For example, if you're having a different type of procedure for Dupuytren's (like a needle fasciotomy), or if you've already had treatment for Dupuytren's in the same finger. We also can't include you if you have another significant hand problem like arthritis, or if you wouldn't be able to complete questionnaires in English.
- Are you 18 or older?
- Are you having Dupuytren's surgery at Dorset County Hospital?
- Do you have a finger bent by 30 degrees or more at the middle knuckle due to Dupuytren's?
- Have you NOT had previous treatment for Dupuytren's in the same finger?
- Can you attend necessary follow-up appointments?
This is a guide only — the research team will confirm whether you can take part.
What does participation involve?
If you decide to take part, you'll be assigned by chance to one of two groups. One group will receive the special four-week therapy before surgery, which includes heat, stretching, massage, and gentle serial casting, along with information about Dupuytren's and what to expect from surgery. The other group will only receive the information session before surgery, without the special therapy.
All participants will have their surgery as planned. After surgery, everyone will follow the usual recovery programme and attend follow-up appointments for up to 12 weeks. During these appointments, we will gather information about how your hand is recovering, such as finger movement and strength. The total time you'd be involved in the study, from starting the pre-surgery therapy or education to the final follow-up, would be about 3-4 months.
Potential risks and benefits
Locations (1)
- Dorchester County Hospital NHS Foundation TrustDorchester, United Kingdom
Common questions
What is Dupuytren's contracture?
It's a common hand condition where the tissue under the skin in your palm tightens, causing your fingers to bend inwards and making it hard to straighten them.
What is 'serial casting'?
It's a gentle way to stretch tight tissues using soft casts that are adjusted weekly, gradually encouraging the finger to straighten before surgery.
Will I definitely get the special therapy?
You'll be randomly assigned to either the group that receives the special therapy or the group that only receives education before surgery. It's like flipping a coin.
Where is the study taking place?
The study is taking place at Dorset County Hospital.
Will my regular care be affected if I don't join?
No, your regular care and treatment for Dupuytren's contracture will not be affected if you choose not to take part in the study.
How to find out more
Tahra Babiker-Moore
Always speak to your GP or specialist before deciding to take part in a study.
Interested in taking part?
Discussion
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