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

• Published in: Hand surgery Vol. 20; no. 3; p. 386
• Main Authors: Tay, Terence Khai Wei, Tien, Huey, Lim, Elizabeth Yenn Lynn
• Format: Journal Article
• Language: English
• Published: Singapore 01-10-2015
• Subjects: Aged; Collagenases - therapeutic use; Dupuytren Contracture - drug therapy; Dupuytren Contracture - surgery; Fasciotomy; Female; Finger Joint; Humans; Injections, Intra-Articular; Male; Metacarpophalangeal Joint; Middle Aged; Orthopedic Procedures; Patient Satisfaction; Retrospective Studies; Treatment Outcome; Collagenase; Open partial fasciectomy; Dupuytren’s disease; Joint contracture
• ISSN: 1793-6535
• DOI: 10.1142/S0218810415500288

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.
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.
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.
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.