The Use of CMMS (Casting Motion to Mobilise Stiffness) to Regain Digital Flexion Following Dupuytren's Fasciectomy

摘要

A principle priority of hand therapy following Dupuytren's Fasciectomy is to regain and maintain extension of the Proximal Interphalangeal Joint (PIPj). Historically this has been achieved through the application of mechanical stress to the affected digit with splinting and exercise. However, loss of a normal pattern of digital flexion in both the operated and non-operated digits is a common complication of this procedure. This case series report demonstrates the effectiveness of using the Casting Motion to Mobilise Stiffness Technique (CMMS) to manage post-operative Dupuytren's Fasciectomy complications when traditional treatment has failed. Four patients who underwent a Dupuytren's Fasciectomy and presented with generalised stiffness and swelling of the operated hand were treated with traditional therapy, which was ineffective. The CMMS technique was therefore applied. The type of casts that were applied, the duration of casting, duration of sessions and cast exercises are described. The outcomes indicate that all patients regained normal digital flexion. The use of the CMMS technique is beneficial as it provides a means to regain digital flexion without the loss of PIPj extension and is successful even when traditional therapy has failed.