Percutaneous sonography-guided treatment of Dupuytren contracture under liquid immersion. Case reports

Dupuytren's contracture is a fibrotic disorder of the palmar fascia, leading to debilitating finger deformities. Traditional treatments, like open fasciectomy and collagenase injection, carry high risks of complications and recurrence. Ultrasound-guided techniques offer a potentially safer, minimally invasive alternative but are limited by the irregular skin surfaces and flexion deformities in Dupuytren's disease. The Sono-Bath, which immerses the hand in sterile liquid during the ultrasound-guided procedure, improves visualization and facilitates the use of cutting instruments.

Two patients with Dupuytren's contracture were treated using the Sono-Bath. Under local anesthesia, the hand was immersed in sterile saline, allowing for enhanced sonographic imaging. The sterile liquid medium minimized tissue deformation and maintained a clear view of the pathological cords. Using the Sono-Bath, the surgeon was able to precisely position the ultrasound probe at a distance, improving visualization and access to the target area. Percutaneous release of the cords was performed through small punctures, using specialized cutting instruments guided by real-time ultrasound, ensuring accurate and safe cord division.

Both cases were successful, achieving full finger extension without complication. The Sono-Bath improved cord visualization and targeting, enabling safer and more effective procedures. Patients reported minimal discomfort.

The Sono-Bath offers a novel, safer approach for minimally invasive treatment of Dupuytren's contracture, enhancing visualization during ultrasound-guided procedures. It also shows potential for broader applications in hand surgery, such as foreign body removal and abscess drainage.