Purpose
The aim of this study was to analyze the durability of the treatment results of the
thumb and first web contractures in Dupuytren disease with collagenase Clostridium histolyticum.
Methods
Twelve patients (14 hands) were followed for an average of 35 months (range, 24–42
months). Two patients (3 hands) were excluded, yielding 11 hands available for assessment.
Nondurability was defined as a worsening of at least 20° of passive extension deficit
at a treated joint or any decrease greater than 5 mm in intermetacarpal head distance,
both relative to 30 days after injection or as intervention to correct new/worsening
contracture. Durability was compared with that of a historic cohort of treated finger
contractures.
Results
Five out of 11 patients with a metacarpophalangeal or interphalangeal joint contracture
or first web contracture had a nondurable result at an average of 35 months. Results
obtained at metacarpophalangeal joints of thumbs were more durable than those of interphalangeal
joints. Most of the recurrences occurred in interphalangeal joints.
Conclusions
Treatment of thumb and first web contractures was not durable in nearly half of the
cases at an average follow-up of 35 months, and durability was clearly less than that
of treated finger contractures.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: November 09, 2018
Accepted:
October 3,
2018
Received:
January 16,
2018
Footnotes
During the course of the study, P.M.N.W was a member of the advisory boards of Pfizer Lts and Sobi Ltd. At present he is on the scientific advisory board of Fidia Pharma (Milan, Italy). The Department of Plastic Surgery at University Medical Centre Groningen receives his honorarium, which is used for research purposes and he is reimbursed for his travel costs. The rest of the authors declare that they have no relevant conflicts of interest.
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