Comparison between Collagenase Injection and Partial Fasciectomy in the Treatment of Dupuytren’s Contracture

Hand Surgery ◽  
2015 ◽  
Vol 20 (03) ◽  
pp. 386-390 ◽  
Author(s):  
Terence Khai Wei Tay ◽  
Huey Tien ◽  
Elizabeth Yenn Lynn Lim
Keyword(s):  
Patient Satisfaction ◽  
Treatment Options ◽  
Group Versus ◽  
Dupuytren’S Contracture ◽  
Extension Deficit ◽  
Treatment Methods ◽  
Dupuytren's Contracture ◽  
Early Return ◽  
Collagenase Injection ◽  
Partial Fasciectomy

Background: A comparative study between two treatment methods (collagenase injection and open partial fasciectomy) for Dupuytren’s contracture. This study will determine differences in clinical outcome, complication rate and patient satisfaction. Methods: 37 patients with 62 metacarpophalangeal joints (MCP) and 44 proximal interphalangeal joints (PIP) treated. There were 21 MCP joints (34%) and 8 PIP joints (18%) treated with injection. The remaining 66% of MCP joints and 82% of PIP joints were treated by open partial fasciectomy. Results: Overall, both treatment methods were successful in correcting the passive extension deficit in the MCP and PIP joints. Minor complications were reported in 45% of patients in the injection group versus 42% in the surgery group. Patient satisfaction was nearly equal for both groups. Conclusions: Both treatment options have proven their effectiveness in treating Dupuytren’s contracture. Open surgery is able to address additional joint contracture problems commonly associated with Dupuytren’s disease. Collagenase injection has the advantage of early return of hand function and avoidance of surgical complications.

Three-year recurrence of Dupuytren’s contracture after needle fasciotomy and collagenase injection: a two-centre randomized controlled trial

2018 ◽  
Vol 43 (8) ◽  
pp. 836-840 ◽  
Author(s):  
Peter Scherman ◽  
Per Jenmalm ◽  
Lars B. Dahlin
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Dupuytren’S Contracture ◽  
Recurrence Rates ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Dupuytren's Contracture ◽  
Randomized Controlled ◽  
Collagenase Injection ◽  
Index Treatment

Collagenase injection and needle fasciotomy have similar short-term outcomes in the treatment of Dupuytren’s contracture. The purpose of this study was to compare the recurrence rate of these two procedures 3 years after index treatment of primary disease. We enrolled 93 patients (96 rays) from a previous two-centre randomized controlled trial. The rays that had been retreated or showed an increase in the total passive extension deficit of 30° or more compared with 3 months after treatment were regarded as recurrences. Seventeen of 40 needle fasciectomies and 12 of 36 of collagenase injections had recurred. This difference was not statistically significant. We conclude that collagenase injection and needle fasciotomy have similar 3-year recurrence rates in the treatment of Dupuytren’s contracture. Level of evidence: I

One-year results of needle fasciotomy and collagenase injection in treatment of Dupuytren’s contracture: A two-centre prospective randomized clinical trial

2015 ◽  
Vol 41 (6) ◽  
pp. 577-582 ◽  
Author(s):  
P. Scherman ◽  
P. Jenmalm ◽  
L.B. Dahlin
Keyword(s):  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Joint Involvement ◽  
Dupuytren’S Contracture ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Dupuytren's Contracture ◽  
Collagenase Injection ◽  
Before And After ◽  
One Year

The objective of this study was to compare early and 1 year outcome of needle fasciotomy and collagenase injection for Dupuytren′s disease. Inclusion criteria were primary Dupuytren’s contracture excluding the thumb with a palpable cord and a total extension deficit, i.e. a fixed flexion from 30° to 135° with less than 60° in the proximal interphalangeal joint. The most affected ray was randomized to either treatment at two centres. Passive extension deficits for each joint before and after treatment, and at 3 and 12 months, were recorded together with complications. A total of 96 rays in 93 patients were included. The average total extension deficits before treatment were 60° or more in both groups, and were largely made up of contractures at the metacarpophalangeal joints. The deficits were reduced by 75% in both groups at 3 months and by 70% in both groups at 12 months. Four patients in the needle fasciotomy group and eight patients in the collagenase group had skin ruptures. At 3 months and 1 year, the outcomes of needle fasciotomy and collagenase injection are the same in Dupuytren’s disease with predominantly metacarpophalangeal joint involvement. Level of evidence: 2.

scholarly journals Needle Fasciotomy or Collagenase Injection in the Treatment of Dupuytren’s Contracture

2020 ◽  
Vol 8 (1) ◽  
pp. e2606
Author(s):  
Islam Abdelrahman ◽  
Moustafa Elmasry ◽  
Ingrid Steinvall ◽  
Christina Turesson ◽  
Folke Sjöberg ◽  
...  
Keyword(s):  
Dupuytren’S Contracture ◽  
Dupuytren's Contracture ◽  
Collagenase Injection

Collagenase Injection for Severe Pipj Induced Dupuytren's Contracture Augmented By a Novel Orthotic Intervention and Therapy Protocol

2012 ◽  
Vol 25 (4) ◽  
pp. e11
Author(s):  
Terri Skirven ◽  
Lauren DeTullio ◽  
Marianne Dunphy ◽  
Abdo Bachoura ◽  
Sidney M. Jacoby ◽  
...  
Keyword(s):  
Dupuytren’S Contracture ◽  
Dupuytren's Contracture ◽  
Collagenase Injection ◽  
Therapy Protocol

Percutaneous needle fasciotomy for primary Dupuytren’s contracture

2011 ◽  
Vol 36 (7) ◽  
pp. 548-552 ◽  
Author(s):  
L. Rahr ◽  
P. Søndergaard ◽  
T. Bisgaard ◽  
T. Baad-Hansen
Keyword(s):  
Open Surgery ◽  
Tendon Rupture ◽  
Sensory Nerves ◽  
Dupuytren’S Contracture ◽  
Extension Deficit ◽  
Joint Contractures ◽  
Dupuytren's Contracture ◽  
Rehabilitation Period ◽  
Severe Comorbidity ◽  
The Individual

This study evaluated the effect of percutaneous needle fasciotomy on primary Dupuytren’s contracture in 149 patients (213 rays) admitted to our clinic in 2007. Ninety-two patients (130 rays) were followed up for 2 years to compare the change in total passive extension deficit and the passive extension deficit across the individual joint and to note side effects. No tendon rupture or damage to sensory nerves was observed and the rehabilitation period was short (mean, 0.6 days). We found a significant change ( p < 0.001) in total passive extension deficit after 2 years, but the effect of the treatment was greater in Tubiana I and II stages and our best results were in correction of MCP joint contractures. Percutaneous needle fasciotomy is an alternative treatment for elderly patients with severe comorbidity or for those patients who do not want open surgery.

The quantitative role of flexor sheath incision in correcting Dupuytren proximal interphalangeal joint contractures

2015 ◽  
Vol 41 (6) ◽  
pp. 609-613 ◽  
Author(s):  
P. E. Blazar ◽  
E. W. Floyd ◽  
B. E. Earp
Keyword(s):  
Case Series ◽  
Tendon Sheath ◽  
Flexion Contracture ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Contracture ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Joint Contractures ◽  
Dupuytren's Contracture

Controversy exists regarding intra-operative treatment of residual proximal interphalangeal joint contractures after Dupuytren’s fasciectomy. We test the hypothesis that a simple release of the digital flexor sheath can correct residual fixed flexion contracture after subtotal fasciectomy. We prospectively enrolled 19 patients (22 digits) with Dupuytren’s contracture of the proximal interphalangeal joint. The average pre-operative extension deficit of the proximal interphalangeal joints was 58° (range 30–90). The flexion contracture of the joint was corrected to an average of 28° after fasciectomy. In most digits (20 of 21), subsequent incision of the flexor sheath further corrected the contracture by an average of 23°, resulting in correction to an average flexion contracture of 4.7° (range 0–40). Our results support that contracture of the tendon sheath is a contributor to Dupuytren’s contracture of the joint and that sheath release is a simple, low morbidity addition to correct Dupuytren’s contractures of the proximal interphalangeal joint. Additional release of the proximal interphalangeal joint after fasciectomy, after release of the flexor sheath, is not necessary in many patients. Level of Evidence: IV (Case Series, Therapeutic)

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