Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Guggenbichler, T.
Treatment of Dupuytren’s disease
Comparison of functional outcome between non surgical collagenase treatment and fasciectomy
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2015. pp. 84
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Hubmer Martin
- Parvizi Daryousch
- Altmetrics:
- Abstract:
- Palmar fasciectomy is still the accepted gold standard in the treatment of Dupuytren’s disease (1). Since 2011 a new treatment option has been made available in Europe, called Xiapex, which enables the nonsurgical treatment of Dupuytren’s disease. It consists of the injectable collagenase clostridium histolyticum consisting of two distinct collagenases AUX I and AUX II (2). The aim of the present thesis is to research the outcome in patients treated with fasciectomy compared to those treated using Xiapex. Methods: For this thesis I retrospectively analysed patients in the MEDOCs System, who underwent either fasciectomy or Xiapex injection within the last two years at the department of plastic surgery at the State Hospital in Graz. Patients were examined preoperative, and then two weeks and six weeks after treatment. There were 11 patients in the Xiapex group and 12 patients treated with fasciectomy. The outcome after these two different interventions was measured using subjective and objective methods. For subjective measurement the Michigan Hand outcome Questionnaire and the DASH score were used. Objective methods included: Sensibility based on Semmes Weinstein Monofilaments, progress of Dupuytren’s contracture in PIP and MCP, total range of motion, strength level of the injured hand, and measurement of pain sensitivity on the basis of the VAS scale in rest and in motion. Results: On the basis of boxplots of the median of the differences significantly better results could be proved in subjects treated with Xiapex in 6 out of 15 tested scores. Further regression models were created to prove the influence of the age and factor time. Significantly better results for Xiapex could be proved in 9 out of 15 tested scores. In 6 out of this 15 scores patients had significantly better results six weeks after intervention than two weeks after it Conclusion: Although the number of patients analysed is relatively low, there were significantly better results in people treated with Xiapex compared to those who underwent total fasciectomy. It would be interesting and worthwhile to conduct studies on the long term success or recurrence rate of patients treated with Xiapex.