Percutaneous Needle Fasciotomy +/- Corticosteroid Injection for Dupuytren's Contracture

Percutaneous Needle Fasciotomy (PNF) +/- Corticosteroid Injection for Dupuytren's Contracture (DC) Affecting Metacarpophalangeal Joints (MCP) . A Randomized Controlled Trial

Comparing percutaneous needle fasciotomy +/- corticosteroid injection for Dupuytren's contracture affecting metacarpophalangeal joints. A clinician-initiated, multicenter, randomized controlled trial.

Sufficient correction of metacarpophalangeal (MCP) joint during the PNF treatment, defined as <20° passive extension deficit (PED), is a prerequisite for inclusion.

Inclusion Criteria:

• Dupuytren contracture (DC) of ≥ 20° PED in MCP joint measured with a goniometer
• DC of either II-V finger
• Well-defined/palpable cord

Exclusion Criteria:

• Legally incapacitated
• Previous study inclusion with another finger ray
• Isolated proximal interphalangeal (PIP) or distal interphalangeal (DIP) joint contracture, defined as MCP joint contracture < 20° PED regardless of the deficit in the PIP or DIP joint
• Previous hand surgery of the affected finger for any reason
• Known allergy to the study medication
• Anticoagulant therapy (Acetylsalicylic acid is NOT an exclusion criterion)
• Pregnant or lactation
• Insulin dependent diabetes mellitus
• Ongoing systemic infection or local infection at the site of the procedure
• Rheumatoid arthritis
• Amyloidosis or mucopolysaccharidosis
• Unable to communicate, cooperate or participate in follow-up