Terence Khai Wei Tay1, Huey Tien2, Elizabeth Yenn Lynn Lim3. 1. ‡ Department of Orthopaedics, University of Malaya, Malaysia. 2. * C.M. Kleinert Institute for Hand and Microsurgery, Louisville, KY, USA. 3. † Department of Otolaryngology, University of Malaya, Malaysia.
Abstract
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.
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.
Entities:
Keywords:
Collagenase; Dupuytren’s disease; Joint contracture; Open partial fasciectomy
Authors: Mikko P Räisänen; Teemu Karjalainen; Harry Göransson; Aleksi Reito; Hannu Kautiainen; Antti Malmivaara; Olli V Leppänen Journal: BMJ Open Date: 2018-03-28 Impact factor: 2.692