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Dupuytren's Nodule Corticosteroid Injection
Aka: Dupuytren's Nodule Corticosteroid Injection
- Indications
- Grade 1 Dupuytren's Disease (Nodule present)
- Preparation
- Needle: 27 gauge (1.5 inch)
- Corticosteroid
- Triamcinolone Acetonide 20 mg or
- Methylprednisolone: 20 mg or
- Celestone Soluspan: 0.5 ml
- Anesthetic
- Lidocaine 1%: 0.5 to 1 ml
- Technique
- Wrist and hand position
- Relaxed hand position with wrist supinated
- Injection site
- Locate Dupuytren's Nodule
- Needle insertion
- Apply antiseptic to skin (e.g. Betadine)
- Consider bending needle 45 degrees
- Inject directly into Nodule
- Parallel to plane of hand
- Approach from each position of a 5-point star
- Top: 12 o'clock
- Sides: 3 and 9 o'clock
- Inferiorly: 5 and 7 o'clock
- Follow-up
- Consider injecting q4-6 weeks for 3-5 injections
- Consider a 6 month hiatus and then restart cycle
- Complications
- Local tenderness at injection site
- Depigmentation or atrophy at injection site
- Flexor tendon rupture
- Efficacy
- Improves hand function and reduces Nodule size
- Significant decrease in those needing surgery
- References
- Ketchum (2000) J Hand Surg 25:1157-62 [PubMed]
- Trojian (2007) Am Fam Physician 76:86-90 [PubMed]