Extracorporeal Shock Wave Therapy in Dupuytren’s Disease
Serkan Aykut1, Canan Aydın2, Kahraman Öztürk1, Fatih Arslanoğlu3, Cem Yalın Kılınç41Department of Hand and Upper Extremity Surgery, Health Sciences University, Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey2Department of Sports Medicine, Health Sciences University, Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey
3Department of Orthopedics and Traumatology, Selahaddin Eyyubi Public Hospital, Istanbul, Turkey
4Department of Orthopedics and Traumatology, Sitki Kocman University, Training and Research Hospital, Istanbul, Turkey
Objectives: We investigated the use of extracorporeal shock wave therapy (ESWT) in patients with Dupuytren’s Disease (DD) palmar nodules in an attempt to reduce the contracture, alleviate the pain (if any), increase the range of motion and quality of life, and delay a probable surgery in the long term.
Methods: Patients with DD who presented to our hand surgery clinic and fulfilled the inclusion criteria were enrolled. The treatment was performed by the same physician using the ESWT device once a week for six weeks. The patients were evaluated with the VAS score, Quick-DASH questionnaire, and MAYO wrist score, and their grip strength was measured using a Jamar dynamometer.
Results: The mean age of the 23 patients included in the study was 51 years. There was a significant improvement in the second measurement of VAS and DASH scores compared with the preoperative values. The increase in the second and final follow-up measurements of the MAYO score and grip strength results compared with the preoperative values was found significant. The table-top test results turned negative in 16 patients.
Conclusion: We can suggest that ESWT in the early term can be preferred over costly injections and surgical intervention options as it increases the quality of life and delays the recurrence of contractures.
Dupuytren hastalığında ekstrakorporeal şok dalga tedavisi
Serkan Aykut1, Canan Aydın2, Kahraman Öztürk1, Fatih Arslanoğlu3, Cem Yalın Kılınç41Health Sciences University, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Department of Hand and Upper Extremity Surgery, Istanbul - Turkey2Health Sciences University, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Department of Sports Medicine, Istanbul - Turkey
3Selahaddin Eyyubi Public Hospital, Department of Orthopedics and Traumatology, Istanbul - Turkey
4Sitki Kocman Univercity, Training and Research Hospital, Department of Orthopedics and Traumatology, Istanbul - Turkey
Amaç: Çalışmamızda palmar nodülü bulunan Dupuytren hastalarında Ekstrakorporeal şok dalga tedavisinin (ESWT) kontraktürlerin azaltılmasına, ağrının azaltılmasına, eklem hareket açıklığına, yaşam kalitesine ve muhtemel cerrahi süresinin gecikmesine olan etkinliğini araştırılması amaçlandı.
Yöntemler: Hastanemiz El Cerrahisi kliniğine müracaat eden kabul kriterlerine uygun olan Dupuytren hastaları çalışma kapsamına alındı. Tüm hastalara aynı uzman tarafından haftada 1 kez olmak üzere 6 hafta süreyle ESWT uygulandı. Hastalar görsel analog skala (VAS), QuickDASH skorlaması, Mayo el bileği skorlaması, el dinamometre sistemleri ile kavrama gücü ölçümü, kullanılarak değerlendirildi.
Bulgular: Ortalama yaşı 51 olan 23 olgu çalışma kapsamına alındı. Tedavi öncesi ölçümlerine göre takiplerde VAS ve Quick-DASH skorlarında anlamlı iyileşme görüldü. MAYO skorlamasında ve kavrama gücünde takip ve son kontrol ölçümlerinde tedavi öncesine göre anlamlı artış saptandı. Olgularımızın 16’unda table –top testinin negatifleştiği görüldü.
Sonuç: Yaşam kalitesini arttırması ve kontraktür tekrarlamasını geciktirmesi nedeniyle daha maliyetli olan enjeksiyon ve cerrahi tedavi seçenekleri yerine erken dönemde kullanılabileceğini düşünmekteyiz.
Manuscript Language: English