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General Orthopaedics

EFFICACY AND SAFETY OF COLLAGENASE INJECTIONS FOR DUPUYTREN'S CONTRACTURE: PROSPECTIVE STUDY IN A DISTRICT GENERAL HOSPITAL

The Indian Orthopaedic Society (UK) (IOSUK)



Abstract

Aim

To determine effectiveness of Collagenase Clostridium Histolyticum (CCH) in deformity correction and hand function for patients with Dupuytren's disease.

Materials & Methods

Patients with MCPJ contractures with no previous surgery to the same finger were included. Treatment consisted of one Xiapex injection to a prominent pretendinous band as an outpatient procedure. Follow up was arranged at 48 hours, 3 weeks and final follow up > 6 months.

Results

17 patients were included. Of the 21 fingers that were studied 14 were right and 7 were left sided. Average age was 69 years (56–82) and mean deformity was 37.6° (10–70). Mean follow up was 11.6 months (SD – 3.13, range 7–17). Post manipulation under correction of deformity was present in 3 fingers which improved by final follow up (mean 6.7°). Three patients had re-appearance of deformity (mean 6.7°). The remaining patients had complete correction of deformity. All deformities were significantly corrected, average correction 35.7° (p<0.05). Michigan hand questionnaire (MHQ) score improved significantly following correction of deformity (p<0.005). The subsets of MHQ – hand function, activities of daily living, aesthetics and satisfaction scores improved significantly (p<0.005).

Conclusion

CCH an effective, minimally invasive option for the treatment of Dupuytren contracture.