Preoperative Serial Casting, Stretching, and Massage Therapy Package for Dupuytren's Patients with Severe Proximal Interphalangeal Joint Contracture: A Feasibility Study Protocol for a Randomised Trial

Preoperative Serial Casting, Stretching, and Massage Therapy Package for Dupuytren's Patients with Severe Proximal Interphalangeal Joint Contracture: A Feasibility Study Protocol for a Randomised Trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Study protocol Preoperative Serial Casting, Stretching, and Massage Therapy Package for Dupuytren's Patients with Severe Proximal Interphalangeal Joint Contracture: A Feasibility Study Protocol for a Randomised Trial Tahra Babiker-Moore, Carol Clark, Timothy B. Crook, Emma Kavanagh This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8779082/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background: Dupuytren’s disease (DD) can lead to fixed flexion contractures of the digits. Although Dupuytren’s fasciectomy (DF) is the standard treatment, outcomes for proximal interphalangeal joint (PIPJ) contractures remain variable. Preoperative therapy may improve soft-tissue extensibility and optimise surgical outcomes, yet its use in hand surgery is largely unexplored. Serial casting has shown potential to improve passive PIPJ extension, but no randomised controlled trials (RCT) have evaluated its use before DF. This feasibility trial aims to determine whether a future RCT of a preoperative therapy protocol, including serial casting, is practical and acceptable. Methods: This single-centre, two-arm, parallel-group randomised feasibility trial will recruit adults with PIPJ contracture >30° awaiting DF. Participants will be randomised 1:1 to an intervention or control group. The intervention comprises a four-week preoperative protocol including heat, stretching, massage, and weekly circumferential thermoplastic casts. All participants will receive a standardised education session. A blinded assessor will collect baseline and 12-week postoperative outcomes: active and passive PIPJ range of motion (ROM), grip strength, and Michigan Hand Questionnaire (MHQ) scores. Qualitative interviews will explore acceptability and experience. Feasibility will be assessed using predefined traffic-light criteria evaluating recruitment, eligibility, randomisation, adherence, retention, acceptability, and maintenance of blinding. Outcomes: Primary outcomes relate to feasibility of trial processes. Secondary outcomes include changes in ROM, grip strength, MHQ scores, and qualitative insights into acceptability. Data will be used to refine study procedures and estimate effect size. Conclusion: This feasibility study will determine whether a full RCT evaluating a preoperative therapy protocol for DF is feasible, acceptable, and appropriately designed. Full Text Additional Declarations No competing interests reported. Supplementary Files AppendixBPatientconsentformfeasibilitystudy14082025V1.1.docx AppendixAPatientinformationsheetfeasibilitystudy03102025V2.docx AppendixCInitialletterofinvitation03102025V2.docx AppendixDDupuytrensEducationLeaflet03102025V1.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 14 Apr, 2026 Reviews received at journal 14 Apr, 2026 Reviewers agreed at journal 08 Apr, 2026 Reviews received at journal 07 Apr, 2026 Reviewers agreed at journal 05 Mar, 2026 Reviewers invited by journal 23 Feb, 2026 Editor assigned by journal 13 Feb, 2026 Submission checks completed at journal 13 Feb, 2026 First submitted to journal 03 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8779082","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Study protocol","associatedPublications":[],"authors":[{"id":596194464,"identity":"2c6bc2c6-e190-4903-8eee-97b9771dd448","order_by":0,"name":"Tahra Babiker-Moore","email":"data:image/png;base64,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","orcid":"","institution":"Bournemouth University","correspondingAuthor":true,"prefix":"","firstName":"Tahra","middleName":"","lastName":"Babiker-Moore","suffix":""},{"id":596194465,"identity":"8e2565fc-99d0-407c-9e93-bfc6768c202d","order_by":1,"name":"Carol Clark","email":"","orcid":"","institution":"Bournemouth University","correspondingAuthor":false,"prefix":"","firstName":"Carol","middleName":"","lastName":"Clark","suffix":""},{"id":596194466,"identity":"6a85c982-beab-406c-8bff-8bc2118e0284","order_by":2,"name":"Timothy B. 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Although Dupuytren’s fasciectomy (DF) is the standard treatment, outcomes for proximal interphalangeal joint (PIPJ) contractures remain variable. Preoperative therapy may improve soft-tissue extensibility and optimise surgical outcomes, yet its use in hand surgery is largely unexplored. Serial casting has shown potential to improve passive PIPJ extension, but no randomised controlled trials (RCT) have evaluated its use before DF. This feasibility trial aims to determine whether a future RCT of a preoperative therapy protocol, including serial casting, is practical and acceptable.\u003c/p\u003e\n\u003cp\u003eMethods:\u003cbr\u003e\nThis single-centre, two-arm, parallel-group randomised feasibility trial will recruit adults with PIPJ contracture \u0026gt;30° awaiting DF. Participants will be randomised 1:1 to an intervention or control group. The intervention comprises a four-week preoperative protocol including heat, stretching, massage, and weekly circumferential thermoplastic casts. 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