Cochrane · systematic review · CD010143
Surgery for Dupuytren's contracture of the fingers
Rodrigues, JN, Becker, GW, Ball, C, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
MusculoskeletalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
13
No studies
8
Included studies
NR
No studies 8 · 38.1%Ungraded 0 · 0%Very low 0 · 0%Low 13 · 61.9%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings table 1: comparison of operation types: early results of needle fasciotomy vs limited fasciectomy for Dupuytren's disease
Population: 125 hands in 121 participants with Dupuytren's disease of the fingers for early outcomes (van Rijssen 2006)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomesa Summary of findings table 1: comparison of operation types: early results of needle fasciotomy vs limited fasciectomy | no estimate extracted | NR | No studies |
DASH hand function score at 5 weeks Major outcome group 1 (hand function) (scores between 0 and 100, where 0 represents no impairment in hand function and 100 represents maximum impairment in hand function) Summary of findings table 1: comparison of operation types: early results of needle fasciotomy vs limited fasciectomy | no estimate extracted | 1 study · 97 participants | Low Downgraded: risk of bias, imprecision |
Patient satisfaction at 6 weeks Major outcome group 2 (other PROM) (scores from "0 (no/very negative) to 10 (yes/very positive)") Summary of findings table 1: comparison of operation types: early results of needle fasciotomy vs limited fasciectomy | no estimate extracted | 1 study · 121 participants | Low Downgraded: risk of bias, imprecision |
Early angular outcome at 6 weeks for Tubiana grade I disease (total passive extension deficit (TPED) of the MCPJ, PIPJ and DIPJ for preoperative contractures with a TPED of 0 to 45 degrees) Early angular outcome at 6 weeks for Tubiana grade II dis... Summary of findings table 1: comparison of operation types: early results of needle fasciotomy vs limited fasciectomy | no estimate extracted | 1 study · 57 participants | Low Downgraded: risk of bias, imprecision |
Major outcome group 4 (recurrence) Summary of findings table 1: comparison of operation types: early results of needle fasciotomy vs limited fasciectomy | no estimate extracted | NR | No studies |
Paraesthesia at 1 week Major outcome group 5 (adverse effects) Defined as "tingling sensations at any part of the treated digit without objective disturbance of sensation at the tip of the digit" per hand Summary of findings table 1: comparison of operation types: early results of needle fasciotomy vs limited fasciectomy | no estimate extracted | 1 study · 117 participants | Low Downgraded: risk of bias, imprecision |
Summary of findings table 2: comparison of operation types: late results of needle fasciotomy vs limited fasciectomy for Dupuytren's disease
Population: 93 participants (van Rijssen 2012a)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
DASH hand function score at 5 years Major outcome group 1 (hand function) (scores between 0 and 100, where 0 represents no impairment in hand function and 100 represents maximum impairment in hand function) Summary of findings table 2: comparison of operation types: late results of needle fasciotomy vs limited fasciectomy | no estimate extracted | NR | No studies |
Patient satisfaction at 5 years Major outcome group 2 (other PROM) (scores between "1 (not at all), 10 (excellent)") Summary of findings table 2: comparison of operation types: late results of needle fasciotomy vs limited fasciectomy | no estimate extracted | 1 study · 93 participants | Low Downgraded: imprecision |
Major outcome group 3 (early angular outcome)b Summary of findings table 2: comparison of operation types: late results of needle fasciotomy vs limited fasciectomy | no estimate extracted | NR | No studies |
Recurrence at 5 years Major outcome group 4 (recurrence) Defined as reoperation or progressive angular deformity of 20 degrees in a successfully treated joint Summary of findings table 2: comparison of operation types: late results of needle fasciotomy vs limited fasciectomy | no estimate extracted | 1 study · 93 participants | Low Downgraded: imprecision |
Major outcome group 5 (adverse effects)d Summary of findings table 2: comparison of operation types: late results of needle fasciotomy vs limited fasciectomy | no estimate extracted | NR | No studies |
Summary of findings table 3: comparison of operation types: firebreak skin grafting vs z‐plasty closure of fasciectomy for Dupuytren's disease
Population: 79 participants (Ullah 2009)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
PEM hand function score at 3 years Major outcome group 1 (hand function) (scores between 0 and 77, where 0 represents no impairment in hand function and 77 represents maximum impairment in hand function) Summary of findings table 3: comparison of operation types: firebreak skin grafting vs z‐plasty closure of fasciectomy | no estimate extracted | 1 study · 79 participants | Low Downgraded: imprecision |
Major outcome group 2 (patient satisfaction and other PROM) Summary of findings table 3: comparison of operation types: firebreak skin grafting vs z‐plasty closure of fasciectomy | no estimate extracted | NR | No studies |
Correction of MCPJ and PIPJ deformities at 2 weeks Major outcome group 3 (early angular outcomes) Summary of findings table 3: comparison of operation types: firebreak skin grafting vs z‐plasty closure of fasciectomy | no estimate extracted | 1 study · 79 participants | Low Downgraded: imprecision |
Progressive contracture by 3 years Major outcome group 4 (recurrence) Summary of findings table 3: comparison of operation types: firebreak skin grafting vs z‐plasty closure of fasciectomy | no estimate extracted | 1 study · 79 participants | Low Downgraded: imprecision |
Hypoaesthesia Major outcome group 5 (adverse effects) Summary of findings table 3: comparison of operation types: firebreak skin grafting vs z‐plasty closure of fasciectomy | no estimate extracted | 1 study · 79 participants | Low Downgraded: imprecision |
Summary of findings table 4: refining rehabilitation: three months of postoperative night splinting with hand therapy vs hand therapy alone for rehabilitation following surgery for Dupuytren's disease
Population: 210 participants with Dupuytren's disease of the fingers in 2 studies (225 digits reported across all studies) (Collis 2013; Jerosch‐Herold 2011)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
DASH hand function score at 3 months Major outcome group 1 (hand function) (scores between 0 and 100, where 0 represents no impairment in hand function and 100 represents maximum impairment in hand function) Summary of findings table 4: refining rehabilitation: three months of postoperative night splinting with hand therapy vs hand therapy alone | no estimate extracted | 2 studies · 205 participants | Low |
Major outcome group 2 (patient satisfaction) Summary of findings table 4: refining rehabilitation: three months of postoperative night splinting with hand therapy vs hand therapy alone | no estimate extracted | NR | No studies |
Total active extension at 3 months Major outcome group 3 (early objective measurement) Total active extension (TAE) of MCPJ, PIPJ and DIPJ; higher value indicates loss of extension and a worse outcome Summary of findings table 4: refining rehabilitation: three months of postoperative night splinting with hand therapy vs hand therapy alone | no estimate extracted | 2 studies · 225 participants | Low |
Major outcome group 4 (recurrence) Summary of findings table 4: refining rehabilitation: three months of postoperative night splinting with hand therapy vs hand therapy alone | no estimate extracted | NR | No studies |
Total active flexion at three months Major outcome group 5 (adverse effects) Total active flexion (TAF) of MCPJ, PIPJ and DIPJ; lower value indicates loss of flexion and a worse outcome Summary of findings table 4: refining rehabilitation: three months of postoperative night splinting with hand therapy vs hand therapy alone | no estimate extracted | 2 studies · 225 participants | Low Downgraded: imprecision |