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

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.