Ultrasound-Guided Percutaneous Needle Fasciotomy after Steroid Injection for Dupuytren's Contracture

Yoo,  Jae Sung; Heo,  Kang; Kim,  Seong Jun; Park,  Kwang Hee; Kim,  Jong Pil

doi:2018.23.1.28

Arch Hand Microsurg > Volume 23(1); 2018 > Article

Original Article

Archives of Hand and Microsurgery 2018;23(1):28-34.
Published online March 1, 2018.
DOI: https://doi.org/10.12790/ahm.2018.23.1.28

Ultrasound-Guided Percutaneous Needle Fasciotomy after Steroid Injection for Dupuytren's Contracture

Jae-Sung Yoo¹, Kang Heo¹, Seong-Jun Kim¹, Kwang-Hee Park¹, Jong-Pil Kim^1,2

¹Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea. kimjp@dankook.ac.kr
²Department of Kinesiology and Medical Science, Graduate School, Dankook University, Cheonan, Korea.

Received: 23 October 2017 • Revised: 12 December 2017 • Accepted: 19 December 2017

Abstract

Purpose
The purpose of this study was to report outcomes of ultrasound-guided percutaneous needle fasciotomy (USPNF) after intralesional steroid injections (SI).

Methods
Tirty-two fingers (fourteen patients) treated by USPNF 4 weeks after intralesional SI from September, 2014 to October, 2016 were reviewed. At 6 months follow-up, outcome measurements were self-reported satisfaction, clinical improvement, clinical success, recurrence and complications.

Results
All fingers showed clinical improvement with 100% satisfaction. Clinical success rates of ring and little fingers were 64.29% and 44.44%, respectively (p=0.18). Clinical improvement were greater in the metacarpophalangeal joint (MCPJ) than the proximal interphalangeal joint (PIPJ), but the difference was not significant (100.00% vs. 84.62%, p=0.07). Superior clinical success was noted in the MCPJ compared to the PIPJ (79.31% vs. 23.08%, p < 0.001). The mean percentages of improvement in the contracture angle were 92.48% for MCPJ and 65.58% for PIPJ. No complication was noted.

Conclusion
Intralesional SI followed by USPNF for the treatment of Dupuytren's contracture showed satisfactory outcomes, USPNF technique can be an alternative to the open technique.

Key Words: Dupuytren contracture, Fasciotomy, Injections