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Case Reports
. 2020 Jun 12;99(24):e20587.
doi: 10.1097/MD.0000000000020587.

Radial extracorporeal shock wave therapy: a novel approach for the treatment of Dupuytren's contractures: A case report

Stefano Brunelli  1 , Cinzia Bonanni  2 , Marco Traballesi  1 , Calogero Foti  2
Affiliations
Case Reports

Radial extracorporeal shock wave therapy: a novel approach for the treatment of Dupuytren's contractures: A case report

Stefano Brunelli et al. Medicine (Baltimore). .

Abstract

Introduction: While the efficacy of focused Extracorporeal Shock Wave Therapy (ESWT) in the treatment of Dupuytren's disease (DD) is supported by one positive trial, the effects of radial ESWT is unclear.

Patient concerns: A 79-year-old man with a 4-year history of impairment of left-hand function and pain due to DD with weakness and flexion deformities of middle and ring fingers. He has not been treated before for this impairment.

Diagnosis: The diagnosis of DD was based on clinical features and ultrasound images.

Interventions: Four weekly sessions of radial ESWT with 1400 impulses 3 bar each, 12 Hz.

Outcomes: The limitations in activities of daily living were analyzed through the Disabilities of Arm Shoulder and Hand Questionnaire (DASH) and Michigan Hand Outcome Questionnaire (MHQ) at baseline, after four sessions of radial ESWT and at 4-months follow-up. Data analysis showed a significant reduction of hand deformities and an improvement of daily living performance. The effects continued at the 4-months follow-up.

Conclusion: This case report demonstrates the feasibility of radial ESWT. Radial ESWT sessions may be carried out by a physiotherapist in outpatient clinics with cost reduction compared with surgical treatment and focused ESWT. Radial ESWT is a non-invasive, well tolerated therapy, so it should be considered in the DD treatment.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Clinical evaluation before treatment: thickening of palmar fascia and flexion deformities of middle and ring fingers with a total flexion deformity of 30°.
Figure 2
Figure 2
One week after the fourth session of radial ESWT. Reduction of nodules and cord dimensions in the palmar fascia with a total flexion deformity of 15°.
See this image and copyright information in PMC

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