Abstract
Objective We have developed a handprint-based method for visualizing and quantifying the palmar
contact of patients with Dupuytren's contracture. The purpose of this study was to
examine whether the generated handprint was useful for assessing the severity of flexion
contracture of the fingers and for evaluating the therapeutic effects of collagenase
clostridium histolyticum (CCH) injection for Dupuytren's contracture.
Methods The handprint was created by applying medical-grade ethanol-containing hand sanitizer
over the entire palmar surface of the affected hand and then pressing it on thermal
paper for word processors. The reliability of the handprint was evaluated through
test–retest of 10 healthy volunteers at an interval of 10 days, and the validity of
the handprint was assessed using a flexion contracture model in which the little finger
was fixed in an Alfence splint. In addition, we obtained handprints of the affected
hand in 33 patients with unilateral Dupuytren's contracture both before CCH injection
and at the final observation after injection to investigate the contact area of the
hand (CAH) and the length of the hand (LH). The relationships between CAH, LH, total
extension deficit angle (TEDA), and patient-reported outcome measures (Japanese Society
for Surgery of the Hand Version of the Quick Disability of Arm, Shoulder, and Hand
Questionnaire [Quick DASH-JSSH] and Hand20) were examined.
Results The test–retest correlation coefficient was 0.9187 (p < 0.001) for CAH and 0.9052 (p < 0.001) for LH, indicating high reliability of the handprint. The ratios of CAH
and LH decreased gradually as the contracture angle of the splinted finger increased.
The handprint revealed a marked improvement of palmar contact after CCH injection
for Dupuytren's contracture. Furthermore, the ratios of CAH and LH were strongly correlated
with TEDA, Quick DASH-JSSH, and Hand20 before treatment.
Conclusion Our handprint-based assessment method was extremely useful for clinical evaluation
of CCH treatment for Dupuytren's contracture.
Type of Study/Level of Evidence Therapeutic.
Keywords
Dupuytren's contracture - handprint - collagenase injection
