Take a look at this article: http://dupuytrens.org/DupPDFs/2012_Agee.pdf

Very interesting that fingers can be straightened to a significant degree mechanically. It still makes me wonder why it won't work to just use a night splint at the first sign of contracture and continue on indefinitely like this. Does wearing s splint just get so annoying that noone can continue indefinitely?

My 5 Cents:

a) you wouldn't like to wear a Digit Widget indefinitely. Have a look at Fig 2 of that paper ....

b) the paper doesn't say how quickly the contracture returns when you stop wearing that device. Fig 9 Shows only a 4 weeks follow-up. That's by far not enough. Contracture will more likely return within maybe 1/2 year.

c) There is a likely chance that the reported improvement achieved by the Digit Widget + surgery could probably also have been achieved by PNF + night splint.

d) a normal night splint is much more comfortable to wear, maybe even for years. It can maintain your current state of contracture and in favourable cases also reduce the contracture a little http://hth.sagepub.com/content/7/3/76.abstract

e) although large and reliable trials on splinting are still missing, anecdotal reports seem to indicate the the contacture comes back quickly when splinting is stopped and that long-term splinting, i.e. over years, stiffens hand and fingers

f) At the Groningen conference in May 2015 the two positions "splinting confers no benefit" and "splinting is beneficial" were presented as an organized controversy. There were no firm conclusions after the discussion, splinting requires more research. Both positions will be published in a book on Dupuytren disease, which will appear in 2016.

Wolfgang

dpjcrfsh:

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Take a look at this article: http://dupuytrens.org/DupPDFs/2012_Agee.pdf

Very interesting that fingers can be straightened to a significant degree mechanically. It still makes me wonder why it won't work to just use a night splint at the first sign of contracture and continue on indefinitely like this. Does wearing s splint just get so annoying that noone can continue indefinitely?

Wolfgang, are you able to post the PDF you have a link to? I can't access without paying.

i totally agree with Wachs 5 cents.

So when the digit wigit is not worn after fingers are straightened, or worn to prevent further curvature it's going to curve back up once stopped unless splinted every night,because it's the build up of collagen that causes the nodes and thickness. How long will it be before the contracture begins again unless the excess collagen is removed. In some cases DD is active others slowly collagen is built up under the facia tissue and some with DD never experience contracture necessary for active treatment.

So the digit wigit is worn again if curvature begins again.How stiff will that proceedure leave the fingers/ hands after a few years. Not much difference than FIXXGLOVE. The collagen is a force to be removed causing DD.

Xiaflex injections dissolves the facia build up caused by extra collagen and scar tissue. That's what I had done. The return of the disease takes time to build up again, even injury can cause the facia thickeness to start the curvature process again. In my case I wear the FIXXGLOVE GLOVE. (See Fixxglove). Very comfortable and the finger bracing piece can be slowly adjusted over a period of time similiar to the digit wigit to slowly straighten fingers depending on the individual cases. There is no difference. They both can prevent premature curvature and straighten fingers over time. However the rate of collagen or node growth cannot be controlled when active. Unless active treatment is used to reduce the facia or node enlargement. It's also different for everyone. I am not a doctor but it seems like the screws could be a source of infection. Also how active can anyone be while wearing a digit wigit. It seems like it would cause a flare rather than help. The Keobner Effect is especially an issue with DD.

It's the Xiaflex that dissolves the collagen material in the facia of the fingers that can help straighten the fingers. The splints continue the treatment by preventing the fingers from contraction at sleep.

Really don't want to sound argumentative, I did read the link three times it does make sense, and also,leaves a lot of questions for many of us with active facia contracture. Once it begins the collagen continues to fill in the facia area. The result is curvature and nodes.

Kind Regards,
Cherise

Hi I forwarded this article to Dr Meinel at Wuerzburg Germany who had advocated the use of splints for decades for his thoughts .
His reply quote "that this in not a splint for a long time- it is a new realization of an old idea to prepare extremely contracted fingers to make them available to fasciectomy / open operation . The concept did not find great acceptance in the scene. It is also too invasive."

Edited 10/10/15 14:24