Collagenase injections as treatment for Dupuytren’s Contraceture - a 1-year follow-up analysis of active extension deficits and Quick-DASH from a midsize Danish hospital

Supervision

Description

Introduction: This study assessed the effectiveness and complications of collagenase injection treatment of Dupuytren’s contracture. We hypothesized that treatment would improve extension deficits and Quick-DASH scores with few severe complications and recovery within a few weeks.
Design: Patients treated with collagenase for Dupuytren’s contracture were prospectively in included in this cohort study. Main and secondary outcome measures were active extension deficits and Quick-DASH scores, respectively. Subsidiary outcomes included achieving a clinically important difference in active extension deficit, complication rates, recovery time and patient satisfaction. Follow-up was at 3 and 12 months. Results: 121 joints (110 patients) were assessed for eligibility. 91 joints (88 patients) were analysed. Active extension deficits improved from 47° (44°-51°) to 8° (5°-12°) for MCP joints and
13 63° (54°-71°) to 35° (26°-44°) for PIP joints immediately after treatment. Significant improvements remained present at 12-months follow-up. Quick-DASH scores improved from 18 (14-21) to 9 (4-13) at 12 months follow-up for MCP joints and from 28 (18-39) to 21 (8-34) for PIP joints. A clinically important difference in active extension deficit was achieved in 81 % of MCP and 36 % of PIP joints. Mild complications were common whereas severe complications were
rare. 90 % recovered within two weeks and 71 % were satisfied.Conclusion: Collagenase injection seems effective for treating Dupuytren’s Contractures, espe
cially in MCP joints. The effect on active extension deficit was immediate and remained present
21 at 12 months follow-up, suggesting some sustainability. Combined with mild complications,
22 brief recovery time and high patient satisfaction, collagenase injections seem viable for treating
23 Dupuytren’s contracture.
Period01/09/201525/01/2016
Target groupMaster