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Dan Med J. 2019 Feb;66(2). pii: A5527.

Clostridium histolyticum as first-line treatment of Dupuytren's disease.

Author information

1
hartig@dadlnet.dk.

Abstract

INTRODUCTION:

The optimal minimal invasive treatment for Dupuytren's contractures (DC) remains debated. The aim of this study was to evaluate the effect of Clostridium histo-lyticum collagenase after 1-4 years of follow-up. The out-comes of this study were 1) overall improvements in degrees from baseline to follow-up; 2) contraction recurrence defined as an extension deficit above 20°, and 3) Hurst endpoint defined as an extension deficit below 5°.

METHODS:

All patients treated with C. histolyticum collagen-ase at the Regional Hospital Horsens from 2013 to 2016 with a minimum of one year of follow-up due to DC were included. The range of motion of the affected finger joint was measured before and immediately after injection and at follow-up. Specific information regarding known co-morbidities to DC was acquired.

RESULTS:

A total of 112 metacarpophalangeal (MCP) and 47 proximal interphalangeal (PIP) joints were included. Total improvement in the range of motion for MCP and PIP joints were 43° and 16°, respectively. The recurrence rate was 9% for MCP joints and 70% for PIP joints. 73% of MCP joints and 9% of PIP joints achieved the Hurst endpoint. 92% of the patients were willing to repeat treatment.

CONCLUSIONS:

Collagenase is a viable first-line treatment for MCP joint contractures. However, results are inferior in the PIP joint.

FUNDING:

This work was supported by the The Scientific Foundation of Horsens Regional Hospital (grant number 00.06-G01-1-17).

TRIAL REGISTRATION:

ClinicalTrials ID NCT03331926.

PMID:
30722822

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