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Original Article



Office-based Percutaneous Needle Fasciotomy for Tubiana Stage 1 and 2 Dupuytren’s Contracture

Zeynel Mert Asfuroğlu, Ender Gümüşoğlu.




Abstract

Purpose
Dupuytren’s contracture (DC) is a common condition that causes flexion contracture of the fingers. Many treatment methods have been described for DC. Patients preferred outpatient treatment options during the COVID-19 pandemic, and percutaneous needle fasciotomy (PNF) can be performed in an office setting. This study reports the results of office-based PNF for Tubiana stage 1 and 2 DC.
Methods
A total of 44 rays in 29 patients (24 males and 5 females) were included. The mean age was 65.2 (49–76) years. Passive extension deficit (PED) of each joint, the visual analog scale (VAS) score for cosmetic appearance, and the Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) questionnaire results were recorded before and after treatment. Complications and recurrence rates were noted. The mean follow-up time was 11.6 (8–16) months.
Results
The PEDs for the metacarpophalangeal and proximal interphalangeal joints decreased in all patients during the early post-treatment period. Q-DASH and cosmetic VAS scores improved in all patients. The recurrence rate was 18% (8 of 44 rays) and a major complication was observed in one patient (rupture of the flexor digitorum profundus tendon).
Conclusion
PNF is a relatively simple procedure that can be performed in an office setting. The functional and cosmetic results were satisfactory in this study, with low recurrence and complication rates. Therefore, PNF may be the first choice treatment option for patients with Tubiana stage 1 and 2 DC.

Key words: Dupuytren’s contracture, percutaneous, needle fasciotomy






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