Radial extracorporeal shock wave therapy for Dupuytren’scontracture: a case report

Parisa Taheri,Shervin Ghaffari Hoseini,Najmeh Salek

doi:10.34172/jsums.2021.16

Abstract

Dupuytren’s contracture (DC) is a fibro-proliferative disorder of palmar and digital fascia, which leads to contracture deformity of hand and consequent disability. There is not a satisfying method for management of the disease and standard invasive treatments such as collagenase injection and fasciectomy have high rates of failure and recurrence. Recently, focused extracorporeal shock wave therapy (ESWT) has been used successfully for reduction of pain and dysfunction in DC. We hypothesized that radial ESWT would benefit this condition and used it in a chronic case. The patient was a 64-year-old farmer with the history of DC in both hands for eight years. He experienced exacerbation in the flexion contracture of the fourth metacarpophalangeal (MCP) joint of his right hand in the past month. We treated the patient with six weekly sessions of radial shock wave. Extension restriction in the fourth MCP joint reached from 30° to normal at the end of treatment and function of hand was also improved. Thus, radial ESWT should be considered and investigated for management of the DC in future studies.

Highlights

Dupuytren’s contracture (DC) or palmar fibromatosis is a benign progressive focal fibro-proliferative condition affecting palmar and digital aponeurosis of the hand [1]
We report the effect of radial Extracorporeal shock wave therapy (ESWT) in a patient with DC
Recently, Knobloch et al proposed that focus shock waves can be used for management of DC [12], as this modality has beneficial effects on disorders with similar pathophysiology such as Peyronie’s disease and Ledderhose’s disease [13,14]

Summary

Introduction

Dupuytren’s contracture (DC) or palmar fibromatosis is a benign progressive focal fibro-proliferative condition affecting palmar and digital aponeurosis of the hand [1]. The comparable efficacy of radial ESWT has made it popular in the field of musculoskeletal conditions [11]. In this case, we report the effect of radial ESWT in a patient with DC. Case Presentation The patient was a 64-year-old male farmer referred to a physical medicine and rehabilitation clinic because of flexion contracture of the fourth metacarpophalangeal (MCP) joint of his right hand. He had noticed the symptoms of the disease since 8 years ago in both hands and recently experienced exacerbation in his right hand deformity. This questionnaire is a self-report tool by which patients can assess the difficulty and interference in daily life on a 5-point Likert scale

Discussion

Conclusion