Low-level laser therapy and Graston technique on recurrence rate of palmar fibromatosis post percutaneous needle fasciotomy

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.