Comparing Treatment Approaches for Dupuytren Contracture: Percutaneous Needle Fasciotomy With and Without Corticosteroids
Bibliographic record
Abstract
INTRODUCTION: Percutaneous needle fasciotomy (PNF) is a standard treatment for Dupuytren contracture. In some instances, clinicians administer intraoperative corticosteroids (ICS) and/or postoperative corticosteroids (PCS) alongside PNF to improve outcomes. However, few studies have systematically investigated the efficacy of ICS and/or PCS as adjuvant therapies to PNF. The purpose of this study was to review clinical outcomes between PNF alone and PNF with corticosteroid use in the treatment of Dupuytren contracture. METHODS: A systematic review was done in February 2024 using SCOPUS and OVID, including all level I-IV studies that reported outcomes of PNF, PNF/ICS, and PNF/PCS. Outcomes of interest included range-of-motion (ROM) improvement at the distal interphalangeal, proximal interphalangeal , and metacarpophalangeal joints of the affected digit, as well as complication rates. Secondary outcomes included Quick Disabilities of the Arm, Shoulder, and Hand scores and Unité Rhumatologique des Affections de la Main scores. RESULTS: Twenty-six studies were included (3,203 PNF patients, 840 PNF/ICS, 81 PNF/PCS, and 921 receiving general corticosteroid use). Twenty-one studies examined PNF alone, six examined PNF/ICS, and three studied PNF/PCS. In studies directly comparing groups, corticosteroid use was associated with greater ROM at final follow-up. PNF alone demonstrated the largest distal interphalangeal ROM gains and superior Disabilities of Arm, Shoulder, and Hand and Unité Rhumatologique des Affections de la Main scores but had the highest and most variable complication rates. PNF/ICS showed the greatest improvement in total joint ROM, while PNF/PCS yielded the largest metacarpal phalangeal and proximal interphalangeal ROM gains. General corticosteroid use showed superior ROM across all joints compared with PNF alone. DISCUSSION: Corticosteroid use alongside PNF improves objective ROM outcomes and reduces complication rates compared with PNF alone. However, subjective improvements favored PNF without corticosteroids. These findings suggest that corticosteroids may enhance functional outcomes while preserving the minimally invasive benefits of PNF.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.034 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.014 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".