Exploring patient outcomes of ultrasound-guided percutaneous needle fasciotomy in the management of Dupuytren’s contracture

BACKGROUND: Dupuytren's contracture (DC) is a fibroproliferative disease causing nodules on the palmar skin. Percutaneous needle fasciotomy (PNF) is a standard treatment option. Ultrasound-guided (USG) surgery has gained traction due to decreased pain and recurrence. This study investigated outcomes of USG-PNF for DC treatment. METHODS: A systematic review on Ovid Medline, Cochrane Library, and Scopus databases identified USG-PNF for DC treatment data. Outcomes included pre- and postoperative Disabilities of the Arm, Shoulder, and Hand (DASH) scores and degree of joint contracture, as well as complications and recurrence. RESULTS: Across nine studies, there were 1036 patients (83% male; mean age 63.8 years) and 1060 USG-PNF treated digits. The average final follow up was at 28.4 months. Metacarpophalangeal joint contractures (n = 485) improved by 15.1% and proximal interphalangeal joint contractures (n = 350) by 20.7%, while distal interphalangeal joint (n = 22) contractures increased by 19%. DASH scores improved by 52.3%. Recurrence occurred in 10.6% of cases, skin tears in 4.5%, postoperative pain in 2.9%, and nerve and tendon injuries each in 0.1%. CONCLUSION: USG-PNF is an alternative treatment method for DC management with metacarpophalangeal joint or proximal interphalangeal joint involvement, demonstrating improved DASH scores and low recurrence and complication rates. Long-term studies are needed to characterize its safety and clinical value.