Nonoperative Treatment of Dupuytren's Contracture: The Use of Ultrasound Imaging to Assess Efficacy

Abstract

Abstract Objective We have used ultrasound imaging technology to objectively demonstrate changes in the degree and quality of diseased fascia in patients with Dupuytren's disease treated nonoperatively with therapeutic splinting and tissue mobilization. Materials and Methods Measurement of active proximal interphalangeal and metacarpophalangeal joint extension along with ultrasound elastography imaging of the fascia was performed prior to, and 6 months after, the initiation of therapy. Results Improvement in active joint extension over the course of therapy was associated with a consistent decrease in the radiologic dimensions of the diseased fascia in combination with qualitative changes in its composition. Conclusion The use of a simple orthosis and soft tissue mobilization techniques have a quantifiable effect on the degree of deformity and the quantity and quality of contracted fascia in Dupuytren's disease, and would appear to have a role in the management of mild to moderate presentations of the disease when enzymatic or surgical interventions may not be practical.