NMM/OMTCase Report

Management of Dupuytren Contracture With Ultrasound-Guided Lidocaine Injection and Needle Aponeurotomy Coupled With Osteopathic Manipulative Treatment

Steven Sampson, DO; Michael Meng, DC; Adam Schulte, OMS III; Drew Trainor, MS, OMS III; Roberto Montenegro, PhD; and Danielle Aufiero, MD
Notes and Affiliations
Notes and Affiliations

Received: May 14, 2010

Accepted: October 21, 2010

Published: February 1, 2011

J Osteopath Med; 111(2): 113-116

Dupuytren contracture is a debilitating disease that characteristically presents as a firm nodularity on the palmar surface of the hand with coalescing cords of soft tissue on the webs and digits. With few nonsurgical modalities providing clinical benefits, open surgical procedures are the standard of care for patients with this condition. However, recent studies have associated surgical intervention with many complications, necessitating further exploration of nonsurgical treatment options. We describe the case of a 64-year-old woman who presented with decreased extension of the fourth and fifth digits on the upper extremities bilaterally; previous conservative treatment regimens had been unsuccessful. After a diagnostic ultrasound, the patient was diagnosed as having Dupuytren contracture and underwent 5 treatments consisting of ultrasound-guided dry-needle aponeurotomy, lidocaine injections, and osteopathic manipulative treatment. During the fifth treatment session, the patient experienced dramatic relief of her symptoms after a palpable release during the manual manipulation portion of her therapeutic regimen. At 2-week follow-up, the patient was symptom-free. Based on this desirable outcome, the authors suggest future research be directed at minimally invasive therapeutic options in the management of Dupuytren contracture.

Read Full Article