The effectiveness of manipulation of fingers with Dupuytren's contracture 7 days after collagenase clostridial histolyticum injection

J Hand Surg Eur Vol. 2020 Mar;45(3):286-291. doi: 10.1177/1753193419890770. Epub 2019 Dec 10.

Abstract

Timing of manipulation of digits after collagenase injection for Dupuytren's disease varies and often takes place within the first few days post-injection. We prospectively investigated the effectiveness of performing manipulation under local anaesthesia 7 days after injection in 100 patients. Demographic data, passive extension deficit, and patient-reported outcome measures were recorded before collagenase injection. Four to 7 weeks after manipulation, passive extension deficit and patient-reported outcome measures improved significantly without the development of any tendon ruptures. Clinical success was achieved in 41% and clinical improvement in 76% of the patients. Adverse events were reported by 85%. The outcomes were comparable with studies with early manipulation, and demonstrate a safe and effective variation to current protocols. We conclude that delaying manipulation to 7 days after collagenase injection is safe and efficient, which allows for flexibility in clinical appointments without negatively affecting outcome. Level of evidence: III.

Keywords: Collagenase; Dupuytren’s; delayed manipulation; patient-reported outcomes.

MeSH terms

  • Collagenases
  • Dupuytren Contracture* / drug therapy
  • Fingers
  • Humans
  • Microbial Collagenase
  • Tendon Injuries*
  • Treatment Outcome

Substances

  • Collagenases
  • Microbial Collagenase