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Binter, A; Neuwirth, M; Rab, M.
Treatment of Dupuytren's disease with collagenase - a 1-year follow-up of 37 patients].
Handchir Mikrochir Plast Chir. 2014; 46(6): 355-360. Doi: 10.1055/s-0034-1395604
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Co-Autor*innen der Med Uni Graz
Neuwirth Maximilian
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Abstract:
The efficiency of collagenase of Clostridium histolyticum (CCH; Xiapex) in the treatment of Dupuytren's contracture has been proved in phase III studies. This retrospective study aims to evaluate our clinical results after the use of CCH. The study included 40 Dupuytren's contractures in 37 patients. There were 32 male and 5 female patients; their average age was 66 years. The most affected finger was the ring finger (55%; 22/40), followed by the little finger (30%; 12/40) and the middle finger (15; 6/40). 14 fingers (35%) presented isolated contractures of the metacarpophalangeal joint whereas an isolated contracture of the proximal interphalangeal joint was evident in 8 (20%) fingers. 18 (45%) fingers presented combined MCP and PIP flexion contractures. None of the patients underwent any treatment prior to this study. A retrospective chart review was performed of all patients. Follow-up examinations were performed seven days, fourteen days, three months, six months and one year after the intervention. The follow-up examination included goniometry of each affected finger to assess the range of motion (ROM) before and after cord breaking. Further patient-reported outcome was accessed concerning postinterventional complaints, impairment of sensibility and satisfaction with the treatment. The range of motion improved in all fingers. Full extension of the affected finger without any contracture could be observed in 93% of the MCP contractures, 38% of the PIP contractures and in 28% of the combined MCP and PIP contractures. Incomplete cord breaking could be observed in 9 (22.5%) fingers. In 8 fingers (20%) skin tears occurred after joint manipulation but healed up without any further surgical intervention. The recurrence rate at the latest follow-up was 2.5% (1/40). Patient satisfaction was high and none of the patients reported any complaints at the latest follow-up. The best results could be achieved in patients with isolated contractures of the MCP joint. Regarding the good functional results, the low complication rates and the high patient satisfaction, CCH represents a simple and effective treatment for Dupuytren's contracture in selected cases. © Georg Thieme Verlag KG Stuttgart · New York.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aged -
Aged, 80 and over -
Collagenases - adverse effects
Collagenases - therapeutic use
Dupuytren Contracture - classification
Dupuytren Contracture - diagnosis
Dupuytren Contracture - drug therapy
Female -
Finger Joint - drug effects
Follow-Up Studies -
Humans -
Male -
Metacarpophalangeal Joint - drug effects
Middle Aged -
Recurrence -

Find related publications in this database (Keywords)
M
Dupuytren
Beugekontraktur
obere Extremitat
Aponeurose
Dupuytren's contracture
bending contracture
upper limb
aponeurosis
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