Arch Hand Microsurg 2018; 23(1): 28-34  
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 Kim1,2
1Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea
2Department of Kinesiology and Medical Science, Graduate School, Dankook University, Cheonan, Korea
Correspondence to: Jong-Pil Kim
Department of Orthopaedic Surgery, Dankook University College of Medicine, 119 Dandae-ro, Dongnam-gu, Cheonan 31116, Korea
TEL: +82-41-550-6579, FAX: +82-41-556-3238, E-mail: kimjp@dankook.ac.kr
Received: October 23, 2017; Revised: December 12, 2017; Accepted: December 19, 2017; Published online: March 1, 2018.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords: Dupuytren contracture, Fasciotomy, Injections


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