Clinical results of collagenase treatment for dupuytren?s disease: a case series study with 2-years follow-up

Acta Ortopédica Brasileira(2023)

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Abstract
Objective: This study aims to report our experience with Clostridium Histolyticum collagenase (CCH) to support the importance of its clinical use and assess its clinical efficacy, complications, and recurrences. Methods: This prospective observational study of 66 patients with a 2-year follow-up. Patients with an exten-sion lag major of 20 degrees at the metacarpophalangeal joint (MPJ) and/or proximal interphalangeal joint (PIPJ) were included. We collected data on demographic and anamnestic details, MPJ and PIPJ contracture degrees, DASH score, complications, and recurrences. Results: The mean pre-injection contracture was 34 degrees for MPJ and 31 degrees for PIPJ. At the 2-year follow-up, the mean contracture for the MPJ and PIPJ were respectively 3 degrees and 14.5 degrees. The mean DASH score decreased from 21.8 before injection to 10,4 after 2 years. The disease recurrence occurred in 34.8% of the patients, all with PIPJ contracture. The main complication was skin breakage (25.7%). Conclusion: The CCH injections remain a consistent option in treating DD; withdrawal from the European market deprives surgeons and patients of low invasiveness and safe tool for treating DD. Level of evidence IV, Therapeutic study investigating treatment results, Case series.
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Key words
Dupuytren Contracture,Palmar Fibromatosis,Microbial Collagenase,Recurrence
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