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The incidence of postoperative flare reaction and tissue complications in Dupuytren’s disease using tension-free immobilization

  • Therapy Articles
  • Published:
HAND

Abstract

Purpose

Open fasciectomy represents a standard treatment of Dupuytren’s disease. Although patients are commonly immobilized in extension to prevent postoperative contracture formation, immobilizing the extremity under tension may precipitate a flare reaction and scar-related complications. This study explores the incidence of flare reaction and other complications with postoperative tension-free splinting after fasciectomy for Dupuytren’s contracture.

Methods

We retrospectively reviewed patients’ charts that consisted of 228 procedures in 191 patients who underwent surgery by the senior author between 2000 and 2010. Postoperative notes were reviewed for wound healing problems, scar appearance, flare reaction, and complications. The grading system defined by Evans et al. was used to standardize flare reaction and scar complications.

Results

Using tension-free splinting, the incidence of flare reaction was 3.5 % (8/228). The eight patients that had flare reactions had mild involvement, and no severe reaction was observed. Fifteen patients had hypertrophic scars, eight had hypersensitive scars, and six had recurrent contractures.

Conclusions

The incidence of flare reaction using tension-free immobilization postoperatively was low in our study. According to our findings, wound healing problems are rare when tensionless splinting is utilized.

Type of study/level of evidence

Case series, Level IV, Therapeutic study

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Conflict of Interest

Michael Rivlin declares that he has no conflict of interest in this article.

Meredith Osterman declares that she has no conflict of interest in this article.

Sidney M. Jacoby declares that he has no conflict of interest in this article.

Terri Skirven declares that she has no conflict of interest in this article.

Uzoma Ukomadu declares that he has no conflict of interest in this article.

A. Lee Osterman declares that he has no conflict of interest in this article.

Declaration (Statement of Informed Consent and Statement of Human and Animal Rights)

The above study was performed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national review board) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008. The study was performed under the guidelines of our institutional review board (Thomas Jefferson University Institutional Review Board); protected patient information was de-identified and has not and would not be used in the publication of this study. Informed consent was not obtained from all patients for being included in the study as the study was determined exempt due to the use of a de-identified radiological database, and no patient identifiers were used in accordance and with the approval of the Institutional Review Board at our institution.

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Authors and Affiliations

  1. Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA

    Michael Rivlin

  2. The Philadelphia Hand Center, Thomas Jefferson University, Philadelphia, PA, USA

    Meredith Osterman, Sidney M. Jacoby, Terri Skirven & A. Lee Osterman

  3. Thomas Jefferson University, Philadelphia, PA, USA

    Uzoma Ukomadu

Authors
  1. Michael Rivlin
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  2. Meredith Osterman
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  3. Sidney M. Jacoby
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  4. Terri Skirven
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  5. Uzoma Ukomadu
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  6. A. Lee Osterman
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Corresponding author

Correspondence to Michael Rivlin.

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Rivlin, M., Osterman, M., Jacoby, S.M. et al. The incidence of postoperative flare reaction and tissue complications in Dupuytren’s disease using tension-free immobilization. HAND 9, 459–465 (2014). https://doi.org/10.1007/s11552-014-9638-6

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  • DOI: https://doi.org/10.1007/s11552-014-9638-6

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