Abstract

Purpose. To investigate the effect of Graston technique and low-level laser therapy (LLLT) on the recurrence rate of palmar fibromatosis after the percutaneous needle fasciotomy (PNF) procedure.

Material and methods. In a randomized controlled trial, 120 patients of both genders, aged 45 to 70 years, were divided into four equal groups of 30 patients each. All participants were diagnosed with stage 2 palmar fibromatosis and underwent surgical release (PNF). Treatment began 5 days post-surgery. Group A received LLLT and the Graston technique in addition to a traditional physical therapy program (ultrasound, hand grip strengthening exercises, night splint) for six weeks, with 18 sessions provided every other day (3 sessions per week). Group B received the Graston technique plus a traditional physical therapy program for six weeks. Group C received LLLT plus a traditional physical therapy program for six weeks. Group D received only the traditional physical therapy program for six weeks. Measurements were conducted using the modified Quick DASH and hand grip assessments before and after the six-week treatment period, as well as evaluations of recurrence rates at 6, 12, and 18 months following the conclusion of the treatment.

Results. Post-treatment comparative analysis across the four groups revealed statistically significant outcomes, with all groups showing notable reductions in Quick DASH scores and significant improvements in hand grip strength (p < 0.01). Detailed intergroup evaluations demonstrated that Group A exhibited superior improvements compared to groups B, C, and D, while Group B showed significant enhancements relative to groups C and D. No substantial differences were noted between groups C and D. Additionally, groups A and B showed significantly lower recurrence rates of palmar fibromatosis at 6, 12, and 18 months compared to groups C and D (p < 0.001).

Conclusions. The combined effect of the Graston technique with LLLT and a traditional program significantly reduces the recurrence rate of palmar fibromatosis compared to the other groups, alongside improvements in hand grip strength and reductions in modified Quick DASH scores.

Key words

palmar fibromatosis, Graston technique, percutaneous needle fasciotomy, Dupuytren disease, hand grip strength, hand grip dynamometer, DASH, recurrence rate